Postoperative effects of low-dose intrathecal morphine in coronary artery bypass surgery
| Autor: | Zeliha Ozer Altunkan, Ugur Oral, Murat Dikmengil, Ismail Cinel, Sebnem Atici, Davud Yapici, Nurcan Doruk, Egemen Bilgin |
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| Rok vydání: | 2008 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Time Factors Meperidine Visual analogue scale Intrathecal morphine law.invention Remifentanil Coronary artery bypass surgery Piperidines law Medicine Humans Postoperative Period Prospective Studies Coronary Artery Bypass Injections Spinal Pain Measurement Pain Postoperative Morphine business.industry Length of Stay Middle Aged Intensive care unit Surgery Cardiac surgery Pethidine Analgesics Opioid Bypass surgery Anesthesia Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of cardiac surgery. 23(2) |
| ISSN: | 0886-0440 |
| Popis: | BACKGROUND Intrathecal morphine has been used in hopes of providing long-lasting postoperative analgesia in patients after cardiac surgery. The aim of this study was to evaluate the effects of 7 micro/kg intrathecal morphine administration in coronary bypass surgery in the postoperative period. METHODS We conducted a prospective, randomized, blinded, and controlled study. Twenty-three patients, who underwent primary elective coronary bypass surgery, were randomly allocated to receive morphine 7 micro/kg intrathecally, before the induction of general anesthesia (Group M, n = 12) or no intrathecal injection (Group C, n = 11). Pain scores, determined by visual analogue scale (VAS), were recorded immediately after extubation upon admission to the intensive care unit (ICU), at the 2nd, 4th, 6th, and 18th hour after extubation. Pethidine was administered if the patient's VAS > or = 4 and consumption was recorded. Extubation time and ICU length of stay were also recorded. RESULTS VAS scores were lower in the Group M at each measured time than the control group (p = 0.016, 0.023, 0.004, 0.0001, and 0.001, respectively). According to the VAS scores, pethidine requirement was lower in the Group M than the control (p = 0.001). Extubation time (3.58 +/- 1.57 vs. 4.86 +/- 1.38 hours, p = 0.045) and ICU length of stay (16.25 +/- 2.70 vs. 19.30 +/- 2.45 hours, p = 0.014) were also significantly shorter in the Group M than the control group. No significant complications were seen in this group of patients. CONCLUSIONS Intrathecal morphine provided effective analgesia, earlier tracheal extubation and less ICU length stay after on-pump coronary bypass surgery. The influence on ICU length of stay requires further evaluations. |
| Databáze: | OpenAIRE |
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