Estañón-García I, López-Jiménez FA

Language: Spanish
References: 19
Page: 93-100
PDF size: 70.62 Kb.

ABSTRACT

Introduction: Intrathecal opioids provide a quite satisfactory postoperational analgesia, and it is estimated that they are effective in controlling acute pain within the first 24 hours after surgery. Material and methods: An experimental, comparative, randomized, and double-blinded study was carried out to compare the effectiveness of low doses against high doses of intrathecal morphine sulfate to handle post operational pain in patients who underwent lumbar-sacra surgery; in addition, pain, nausea and vomit were evaluated. Eighty seven patients were included, distributed randomly in two groups, one with 44 patients and the other with 43. One group was given intrathecal morphine sulfate (200 µg) and bupivacaine (15 µg) at 0.375%. The other group was given morphine sulfate (500 µg) and bupivacaine (15 µg) at 0.375%; both groups were also given balanced general anesthesia. Additionally, patients received ondansetron (8 mg) intravenously. Results: There was no significant difference in statistical terms as to pain and rash in both groups. There was a significant difference six hours after surgery as to postoperational nausea and vomit, being more frequent in the group that was given 500 µg of morphine. Besides, there was a higher frequency of collateral effects such as urinary retention in the group of the higher dose; the other group showed postpuncture headaches. No cases were registered of respiratory depression. Complications were easily controlled and none jeopardized any patient’s life. None of the rash cases required further treatment. Conclusions: Low doses of morphine sulfate are safe and effective in postoperational analgesic in surgery of the lumbar-sacral spine, with a lower incidence of contrary effects.

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