Intrathecal Morphine in Spine Surgery: A Meta-analysis of Randomized Controlled Trials
| Autor: | Lakshmanan Sivasundaram, Alexander Tuchman, Arif Pendi, Gligor Gucev, Rana Movahedi, Ibraheem Arif, Frank L. Acosta |
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| Rok vydání: | 2017 |
| Předmět: |
Nausea
Sedation law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial 030202 anesthesiology law medicine Humans Orthopedics and Sports Medicine Injections Spinal Randomized Controlled Trials as Topic Pain Postoperative Morphine business.industry Odds ratio Evidence-based medicine Spine Analgesics Opioid Anesthesia Meta-analysis Vomiting Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Spine. 42(12) |
| ISSN: | 1528-1159 |
| Popis: | STUDY DESIGN Meta-analysis of randomized controlled trials (RCTs). OBJECTIVE The aim of this study was to evaluate the effectiveness of intrathecal morphine (ITM) in reducing postoperative pain and opioid analgesic consumption following spine surgery. SUMMARY OF BACKGROUND DATA The use of ITM following adult spine surgery is of particular interest because of the ease of access to the thecal sac and the potential to provide adequate analgesia at low doses. However, previous studies of ITM have been limited by small sample sizes and conflicting results. METHODS A comprehensive search of PubMed, Web of Science, Clinicaltrials.gov, and the Cochrane Central Register of Controlled Trials for prospective RCTs was performed by two independent reviewers. Postoperative opioid consumption, pain scores, and complications were documented from the identified studies. Standard mean differences (SMDs) were applied to continuous outcomes and odds ratios were determined for dichotomous outcomes. RESULTS Eight RCTs involving 393 subjects met inclusion criteria and were included in this meta-analysis. Patients receiving ITM (ITM group) as an adjunct to postoperative opioid analgesic were compared to patients receiving postoperative opioids only (control group). Postoperative morphine equivalent consumption was significantly lower during the first 24 hours postoperative in the ITM group (P |
| Databáze: | OpenAIRE |
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