Document Detail


Effect of preoperative oral sustained-release morphine sulfate on postoperative morphine requirements in elective spine surgery.
MedLine Citation:
PMID:  15548244     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sustained-release morphine sulfate (SRMS) is a painkiller used in oncology. The purpose of our study was to assess its efficacy on postoperative morphine requirements in elective spine surgery. This was a placebo-controlled, randomized, double-blind study. Adults scheduled for spine surgery under general anesthesia were orally administered SRMS (30 mg) or a placebo 2 h before surgery. Primary endpoint was postoperative cumulated morphine consumption through patient-controlled analgesia (PCA) during the 12 h following extubation. Statistical analysis was performed using a sequential method, the triangular test. The study was stopped after the sixth analysis (51 patients had been included; placebo: 26, SRMS: 25). Age, weight, sex ratio, type of surgery, intra-operative sufentanil consumption, anesthesia duration and time to extubation were similar in the two groups. Morphine consumption through PCA during the 12 h following extubation was significantly lower in the SRMS group (mean +/- SD: 10.5 +/- 7.6 mg) compared with placebo group (15.6 +/- 6.0 mg, P = 0.016, sequential analysis). Corresponding unbiased median estimates were 10.6 and 15.8 mg in SRMS and placebo groups, respectively. Morphine consumption through PCA during the 24 h following extubation was also significantly lower in the SRMS group (15.9 +/- 12.7 mg) compared with the placebo group (23.8 +/- 10.9 mg, P = 0.032). Vigilance, nausea and respiratory rate 3 and 6 h after extubation were similar in the two groups. A preoperative oral administration of SRMS (30 mg) induces a 33% reduction of postoperative morphine requirements in patients scheduled for spine surgery without inducing side effects.
Authors:
Eric Bellissant; Jean-Pierre Estèbe; Véronique Sébille; Claude Ecoffey
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Fundamental & clinical pharmacology     Volume:  18     ISSN:  0767-3981     ISO Abbreviation:  Fundam Clin Pharmacol     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-11-19     Completed Date:  2005-03-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8710411     Medline TA:  Fundam Clin Pharmacol     Country:  England    
Other Details:
Languages:  eng     Pagination:  709-14     Citation Subset:  IM    
Affiliation:
Centre d'Investigation Clinique INSERM 0203, Unité de Pharmacologie Clinique, Hôpital de Pontchaillou, Université de Rennes 1, 35033 Rennes, France. eric.bellissant@univ-rennes1.fr
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MeSH Terms
Descriptor/Qualifier:
Analgesia, Patient-Controlled
Analgesics, Opioid / administration & dosage,  therapeutic use*
Delayed-Action Preparations
Double-Blind Method
Female
Humans
Male
Middle Aged
Morphine / administration & dosage,  therapeutic use*
Pain, Postoperative / drug therapy*
Spine / surgery*
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Delayed-Action Preparations; 57-27-2/Morphine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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