Korean J Anesthesiol.  2012 Dec;63(6):563-566. 10.4097/kjae.2012.63.6.563.

Intrathecal morphine in two patients undergoing deep hypothermic circulatory arrest during aortic surgery: A case report

• Przkora R
• Martin TD
• Hess PJ
• Kulkarni R

• KMID: 2236261
• DOI: http://doi.org/10.4097/kjae.2012.63.6.563

Abstract

We retrospectively report the first use of intrathecal morphine prior to incision in two male patients undergoing a complex aortic reconstruction, who required complete circulatory arrest under deep hypothermia for intraoperative and postoperative pain control. We administered intrathecal morphine to two male patients undergoing circulatory arrest and deep hypothermia. Patients were fully heparinized prior to cardiopulmonary bypass. Deep hypothermic circulatory arrest was performed by cooling the patients to 18degrees C. Following the surgery, the neurologic status was monitored. The management of postoperative pain is a quality standard in health care. During the first 24 hours after surgery, we observed excellent analgesia without the associated side effects, thus, reducing the time required for pain control by the nursing staff. A successful analgetic strategy not only enhances the patient satisfaction, but may improve the postoperative outcome. However, complications, such as increased risk of epidural hematoma formation, are of special concern in cardiac surgery.

Keyword

Cardiac surgical procedures; Circulatory arrest (hypothermia induced); Morphine; Spinal anesthesia

MeSH Terms

Analgesia
Anesthesia, Spinal
Cardiac Surgical Procedures
Cardiopulmonary Bypass
Circulatory Arrest, Deep Hypothermia Induced
Delivery of Health Care
Hematoma
Heparin
Humans
Hypothermia
Male
Morphine
Nursing Staff
Pain, Postoperative
Patient Satisfaction
Retrospective Studies
Thoracic Surgery
Heparin
Morphine