Regional anesthesia and pain medicine vol. 24 no. 3 may-june supplement 1999 intrathecal morphine for analgesia after hysterectomy : a dose response study

Abstract

Introduction and objectives : In the last years the application of intrathecal ( IT ) morphine for relief of post operative pain has gained clinical acceptance. The initial reluctance to side effects have been overcome by the advantages of consistent-reliable analgesia, and the description of some salutary changes in surgical outcome. Several differences in dose , according type of surgery are observed. The objective of this protocol is to determine the optimal dose of IT morphine to provide analgesia after abdominal hysterectomy. Patients and Methods: In a prospective study , 86 patients undergoing abdominal hysterectomy under combined spinal/epidural anesthesia with a mixture of epinephrine 100 meg + fentanyl 25 mcg+ hyperbaric bupivacaine 7. 5 mg were randomly allocated to receive, in addition , IT morphine in the following doses : 0 - 50 - 100 and 150 meg , plus 75 mg of IV diclofenac every 8 hrs. Pain on rest and during mobilization was assesed by using 100 mm VAS until 36 hrs pos