Intrathecal morphine for postoperative analgesia in thoracic surgery: Single center experience

Year 2022, Volume: 47 Issue: 4, 1722 - 1729, 28.12.2022

Mediha Türktan , Ersel Güleç

https://doi.org/10.17826/cumj.1188244

Abstract

Purpose: The aim of this study was to present our experiences with intrathecal morphine used for postoperative analgesia in the patients underwent thoracic surgery in our clinic.
Materials and Methods: In this study, a total of 18 adult patients who underwent thoracic surgery and were administered intrathecal morphine for postoperative analgesia between January 2020 and June 2020 were evaluated retrospectively. The patients were divided into two groups: Group 1; 10 mcg/kg intrathecal morphine grup, Group 2; 7 mcg/kg intrathecal morphine group. Demographic data, doses of morphine administered, duration of surgery and anesthesia, intraoperative anesthetic agent consumption, postoperative hemodynamic variables, pain scores, additional analgesic requirement and side effects were recorded.
Results: Twelve of the patients (66.7%) were administered 10 mcg/kg and 6 of them (33.3%) 7 mcg/kg intrathecal morphine according to ideal body weight. Intraoperative anesthetic agent consumption was found to be lower in Group 1 compared to Group 2, but this difference was not statistically significant. Pain scores at rest were statistically lower in Group 1 at 12, 24 and 48 hours postoperatively. Pain scores at effort were also statistically lower in Group 1 at 12, 18, 24 and 48 hours postoperatively.
Conclusion: Intrathecal morphine is a safe postoperative analgesia option for thoracic surgery patients. We believe that intrathecal morphine at a dose of 10 mcg/kg provides more effective analgesia than 7 mcg/kg without increasing the frequency of side effects.

Keywords

Analgesia, anesthesia, intrathecal, morphine, thoracic surgery

Toraks cerrahisinde postoperatif analjezide intratekal morfin: Tek merkez deneyimi

Abstract

Amaç: Bu çalışmada kliniğimizde toraks cerrahisi uygulanan hastalarda postoperatif analjezi amaçlı intratekal morfin kullanımı ile ilgili deneyimlerimizi sunmayı amaçladık.
Gereç ve Yöntem: Bu çalışmada Ocak 2020-Haziran 2020 tarihleri arasında toraks cerrahisi geçiren ve postoperatif analjezi amaçlı intratekal morfin uygulanan toplam 18 erişkin hastanın dosyası ve anestezi formları retrospektif olarak incelendi. Grup 1;10 mcg/kg intratekal morfin, Grup 2; 7 mcg/kg intratekal morfin uygulanan grup olarak ikiye ayrıldı. Hastaların demografik verileri, uygulanan morfin dozları, anestezi ve cerrahi süreleri, intraoperatif anestezik ajan tüketimleri, postoperatif hemodinamik verileri, ağrı düzeyleri, ek analjezik ihtiyaçları ve yan etkiler incelendi.
Bulgular: Hastaların 12’sine (% 66,7) ideal vücut ağırlığına göre 10 mcg/kg, 6’sına (%33,3) 7 mcg/kg intratekal morfin uygulandığı tespit edildi. İntraoperatif anestezik ajan tüketimi Grup 1’de Grup 2’ye kıyasla daha düşük bulundu, ancak aradaki fark istatistiksel olarak anlamlı değildi. Postoperatif 12, 24 ve 48. saatlerde dinlenme sırasında bakılan ağrı düzeyleri Grup 1’de istatistiksel olarak daha düşük. Postoperatif 12, 18, 24 ve 48. saatlerde efor sırasında bakılan ağrı düzeyleri de Grup 1’de istatistiksel olarak daha düşük bulundu.
Sonuç: Toraks cerrahisi hastalarında uygulanan intratekal morfin güvenli bir postoperatif analjezi seçeneğidir. Bu amaçla 10 mcg/kg dozunda uygulanan intratekal morfinin 7 mcg/kg’e göre daha etkin analjezi sağladığı kanaatindeyiz.

Keywords

analjezi, anestezi, intratekal, morfin, toraks cerrahisi, Analgesia, anesthesia, intrathecal, morphine, thoracic surgery

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