Anästhesie und klinische Forschung
Offener Zugang

Abstrakt

Comparative Evaluation of Intrathecal Morphine vs. Intravenous Morphine on Post-operative Pain and Pulmonary Function in Patients Undergoing On-pump Cardiac Surgery: A Prospective Randomized Study

Sunder Lal Negi*, Sanjay Kumar, Neetika Katiyar, Sandeep Negi, Shyam Thingnam, Subhrashish Guha Niyogi, KP Gourav

Background: In the era of rapid extubation following cardiac surgery, providing adequate analgesia in perioperative period is utmost important. The aim of the study is to evaluate the effect of low dose Intra Thecal Morphine (ITM) on postoperative analgesia, pulmonary function and postoperative recovery profile.

Methods: Seventy-two patients were randomized to either ITM (n=34) or Intra Venous Morphine (IVM) (n=34) groups. Patients in the ITM group received 350 μg intrathecal morphine followed by general anaesthesia, and IVM group received only general anaesthesia. Comparisons were made between the groups with respect to quality of analgesia and Pulmonary Function (PF) in postoperative period.

Results: In the ITM group, the total consumption of morphine during the first 24 hour was significantly reduced; patients reported less pain scores, and less mechanical ventilation duration. Both groups reported significantly reduced Forced Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC) post-operatively, however no significant decreases observed between groups.

Conclusion: A single dose ITM administration is safe and more effectively reduces postoperative pain and mechanical ventilation duration in patients undergoing on pump cardiac surgery. However, ITM administration did not significantly affects the pulmonary function compared to IVM in post-operative period.