Effect of Intrathecal Morphine in Post Operative Analgesia

Pokharel A*, Karki AJ*

Abstract


INTRODUCTION: Analgesic technique used for effective pain control with minimum side effects will decrease complications and facilitate early recovery during immediate postoperative period. Use of intrathecal morhine as adjunt has been recommended for good postoperative analgesia. The objective of this study is to
assess duration of post operative analgesia with different doses of intrathecal morphine and side effects in postoperative period after vaginal hysterectomy done under subarachnoid block.

METHOD: This is an observational study done in 77 patients undergoing vaginal hysterectomy under spinal anesthesia in surgical camp organized by District Hospital, Ilam. A subarachnoid block was given using intrathecal 0.5% heavy bupivacaine with and without morphine using different dose OF 0.1 milligram, 0.2
milligram and 0.3 milligram(mg) intrathecally as an adjunt. Duration of analgesia and side effect profile of morphine was analysed postoperatively.

RESULT: Duration of postoperative analgesia using only bupivaicaine was 5.313 ± 0.352 hour. With 0.1mg, 0.2mg and 0.3 mg of intrathecal morphine with bupivaicaine, the duration of postoperative analgesia was 23.46 ± 1.29 hours , 62.17±1.43 AND 66.8± 2.86 hours respectively. All Patients with 0.3 mg of intrathecal morphitne developed itching. SIX patients (12.5%) with 0.2 mg of morphine developed itching. No itching was noted in
0.1 mg group.

CONCLUSION: Intrathecal 0.5% heavy bupivacaine mixed with 0.2 mg of morphine as adjunt provides 62.17±1.43 hours of postoperative analgesia with minimum side effects.

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