Efficacy of 0.1 mg of subarachnoid morphine combined with bupivacaine on postoperative analgesia in total hip arthroplasty

To analyze the analgesic efficacy, safety and side effects of subarachnoid morphine (0.1 mg) with bupivacaine in patients undergoing total hip arthroplasty. Thirty patients scheduled for total hip replacement under spinal anesthesia with bupivacaine were randomly assigned to two groups according to...

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Bibliographic Details
Published in:	Revista española de anestesiología y reanimación Vol. 46; no. 10; p. 433
Main Authors:	Mendieta Sánchez, J M, Fernández-Liesa, J I, Marco, G, Panadero, A, Sánchez-Ledesma, M J, Macías, A
Format:	Journal Article
Language:	Spanish
Published:	Spain 01-12-1999
Subjects:	Aged Analgesics, Opioid - administration & dosage Analgesics, Opioid - adverse effects Anesthesia, Spinal - methods Anesthetics, Local - administration & dosage Arthroplasty, Replacement, Hip Bupivacaine - administration & dosage Female Humans Male Middle Aged Morphine - administration & dosage Morphine - adverse effects Pain, Postoperative - prevention & control Subarachnoid Space
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Summary:	To analyze the analgesic efficacy, safety and side effects of subarachnoid morphine (0.1 mg) with bupivacaine in patients undergoing total hip arthroplasty. Thirty patients scheduled for total hip replacement under spinal anesthesia with bupivacaine were randomly assigned to two groups according to whether local anesthetic with 0.1 mg subarachnoid morphine was also provided or not (group M [n = 15] and group S ņ = 15[, respectively). Top-up analgesia with morphine was available through a patient-controlled device. Postoperative pain was assessed on a visual analogue scale (VAS) and consumption of intravenous morphine in the first 48 hours after surgery was recorded. VAS scores (mean +/- SD) were significantly lower in the first six hours in group M, but no differences between the two groups were observed thereafter. Total consumption of morphine at 48 hours was much lower in group M (6.80 +/- 7.74 mg) than in group S (31.38 +/- 13.17 mg). The incidence of nausea was high in both groups (46%). Slight pruritus affected 26.6% of patients in group M. Urinary retention necessitating temporary placement of a catheter was observed only in group M, where the incidence was 35.7%. No cases of respiratory depression occurred. Drowsiness was observed in 26.6% of patients in group S in comparison with 6.6% in group M. Combining 0.1 mg morphine and bupivacaine for total spinal anesthesia during hip arthroplasty significantly decreased the consumption of intravenous morphine during the first 48 hours after surgery. No respiratory depression occurred and the only side effects were urinary retention and mild pruritus and drowsiness.
ISSN:	0034-9356