Abstract

HERRERA GOMEZ, Pedro; GARCIA ULLOA, Adriana  and  ESLAVA SCHMALBACH, Javier. Ensayo clínico doble ciego, controlado para evaluar la efectividad analgésica de 100 microgramos de morfina intratecal en el control del dolor postoperatorio. Rev. colomb. anestesiol. [online]. 2006, vol.34, n.1, pp.9-14. ISSN 0120-3347.

Background: Intra-thecal morphine is an excellent alternative for the management of post-operative pain in patients receiving spinal anesthesia. The post-operative analgesic effectiveness of 100µg of morphine added to a local anesthetic has only been assessed in patients undergoing cesarean sections, and transurethral resection of the prostate and joint replacements in the elderly. The purpose of this study is to assess the analgesic effectiveness of 100µg of intra-thecal morphine in young adults undergoing lower abdominal or lower limb surgery. Methods: Multi-center, double-blind, randomized clinical trial with 140 patients. Seventy (70) patients received 100µg of morphine added to the local anesthetic (study group). The other seventy were managed with conventional pain relief treatment (control group). Analgesic effectiveness and side-effects were studied over a 35-hour period after the administration of intra-thecal morphine. Results: The dose of morphine was effective for controlling pain immediately following surgery. The analgesic effect lasted during the 35-hour follow-up period in the study group and it was particularly noticeable in the immediate post-operative period (NNT=2). In our study, the incidence of side-effects was as follows: itching, 60% (NNH=2); nausea and vomiting, 25% (NNH=11); urinary retention, 24.3% (NNH=5) and respiratory depression, 0%. There were no differences in the characteristics of the anesthesia or the hemodynamic behavior between the two groups. Conclusions: Morphine at a 100 µg dose provides effective pain relief within the first twelve hours. Sideeffects were tolerable and required no treatment.

Keywords : Intra-thecal opioids; morphine; post-operative pain; analgesia.

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