Continuous Morphine Plus Injection Preemptive Pain Option

Approach compares favorably with continuous subcutaneous morphine alone after lumbar fusion
By Beth Gilbert
HealthDay Reporter

FRIDAY, July 30 (HealthDay News) -- Preemptive analgesia using continuous subcutaneous morphine combined with a single intrathecal injection of morphine (SI) in patients who undergo posterior lumbar interbody fusion provides a favorable analgesic effect and compares favorably with continuous subcutaneous morphine alone (SC), according to a study published in the July issue of the Journal of Spinal Disorders & Techniques.

Yasutsugu Yukawa, M.D., of Chubu Rosai Hospital in Nagoya, Japan, and colleagues evaluated 44 patients who had undergone posterior lumbar interbody fusion with instrumentation. Twenty-two patients were given SI, and 22 patients who had received SC in a previous study were used as controls.

The researchers found that, from immediately after surgery up to 24 hours, the Visual Analog Scale (VAS) was significantly lower in the SI group compared to the SC group, with the average VAS for the SI group below 30 at any given time point. While there were no significant differences in the use of supplemental analgesic drugs between the SC and SI groups, the time to first request for supplemental analgesic was shorter for the SC group compared to the SI group. More cases of minor side effects occurred in the SI group compared to the SC group (six versus three cases), with one patient in the SI group requiring use of a nasal airway for a few hours due to mild respiratory depression.

"Continuous subcutaneous morphine combined with an intrathecal morphine injection can be an attractive method for postoperative analgesia and accomplished with technical ease," the authors write.

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