Korean J Anesthesiol.  2007 Feb;52(2):172-178. 10.4097/kjae.2007.52.2.172.

Effect of Intrathecal Morphine for Total Knee Replacement Arthroplasty Elderly Patients

• Hur MJ
• Kim YJ
• Baik HJ
• Kim JH

• KMID: 2236620
• DOI: http://doi.org/10.4097/kjae.2007.52.2.172

Abstract

BACKGROUND
Low-dose intrathecal opioid has been used for early postoperative pain co1ntrol. This study was designed to assess effect intrathecal morphine on postoperative pain control for total knee arthroplasty (TKA) under combined spinal-epidural analgesia (CSE) in elderly patients.
METHODS
Fifty four patients over 60 years, undergoing TKA were randomly allocated to three groups. M(0) group for control group did not received intrathecal morphine, M(50) and M(100) group received intrathecal morphine 50microgram and 100microgram respectively. The pain scores (verbal numeric rating scale, VNRS) at rest and coughing, analgesic consumption, patient satisfaction and side effects such as nausea, vomiting, pruritus, headache, dizziness, sedation, respiratory depression, and urinary retention were recorded immediately before and at 1, 3, 6, 12, 24, 48 hour after the initiation of patient-controlled epidural analgesia (PCEA).
RESULTS
VNRS were low at each time, and were not exceeding 2 in all groups. M(50) and M(100) group revealed significantly less analgesic consumption compared to M(0) group (P < 0.05). PCEA first injection time after PCEA connection was shortest in M(0) group compared to M(50) and M(100) group. The incidence of pruritus increased in M(50) and M(100) group with dose-dependence, but no significant differences were noticed in other side effects.
CONCLUSIONS
Intrathecal morphine use showed no significant analgesic effect except pruritus compared to control group. Further studies are required into the effective intrathecal morphine without side effects in elderly patients for TKA.

Keyword

analgesia; morphine; patient-controlled epidural analgesia; total knee arthroplasty

MeSH Terms

Aged*
Analgesia
Analgesia, Epidural
Arthroplasty*
Arthroplasty, Replacement, Knee*
Cough
Dizziness
Headache
Humans
Incidence
Knee
Morphine*
Nausea
Pain, Postoperative
Patient Satisfaction
Pruritus
Respiratory Insufficiency
Urinary Retention
Vomiting
Morphine