Document Detail


Postoperative effects of low-dose intrathecal morphine in coronary artery bypass surgery.
MedLine Citation:
PMID:  18304128     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intrathecal morphine has been used in hopes of providing long-lasting postoperative analgesia in patients after cardiac surgery. The aim of this study was to evaluate the effects of 7 micro/kg intrathecal morphine administration in coronary bypass surgery in the postoperative period. METHODS: We conducted a prospective, randomized, blinded, and controlled study. Twenty-three patients, who underwent primary elective coronary bypass surgery, were randomly allocated to receive morphine 7 micro/kg intrathecally, before the induction of general anesthesia (Group M, n = 12) or no intrathecal injection (Group C, n = 11). Pain scores, determined by visual analogue scale (VAS), were recorded immediately after extubation upon admission to the intensive care unit (ICU), at the 2nd, 4th, 6th, and 18th hour after extubation. Pethidine was administered if the patient's VAS > or = 4 and consumption was recorded. Extubation time and ICU length of stay were also recorded. RESULTS: VAS scores were lower in the Group M at each measured time than the control group (p = 0.016, 0.023, 0.004, 0.0001, and 0.001, respectively). According to the VAS scores, pethidine requirement was lower in the Group M than the control (p = 0.001). Extubation time (3.58 +/- 1.57 vs. 4.86 +/- 1.38 hours, p = 0.045) and ICU length of stay (16.25 +/- 2.70 vs. 19.30 +/- 2.45 hours, p = 0.014) were also significantly shorter in the Group M than the control group. No significant complications were seen in this group of patients. CONCLUSIONS: Intrathecal morphine provided effective analgesia, earlier tracheal extubation and less ICU length stay after on-pump coronary bypass surgery. The influence on ICU length of stay requires further evaluations.
Authors:
Davud Yapici; Zeliha Ozer Altunkan; Sebnem Atici; Egemen Bilgin; Nurcan Doruk; Ismail Cinel; Murat Dikmengil; Ugur Oral
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  23     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2008 Mar-Apr
Date Detail:
Created Date:  2008-02-28     Completed Date:  2008-05-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  140-5     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Intensive Care, University of Mersin, Mersin 33079, Turkey. davudyapici@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Analgesics, Opioid / administration & dosage*
Coronary Artery Bypass / adverse effects*
Female
Humans
Injections, Spinal
Length of Stay
Male
Meperidine / administration & dosage
Middle Aged
Morphine / administration & dosage*
Pain Measurement
Pain, Postoperative / drug therapy*,  prevention & control
Piperidines / administration & dosage
Postoperative Period
Prospective Studies
Time Factors
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Piperidines; 132875-61-7/remifentanil; 57-27-2/Morphine; 57-42-1/Meperidine

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


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