Safety and side-effect profile of intrathecal morphine in a diverse patient population undergoing total knee and hip arthroplasty
- 154 Downloads
Intrathecal morphine (ITM) can be useful for postoperative analgesia following lower extremity joint arthroplasty, but concerns exist regarding potential dose-related side effects. In this study, we examined the safety and efficacy of ITM in patients undergoing lower extremity joint arthroplasty. We hypothesized that there would be (1) direct relationship between dosing and side effects, and (2) an inverse relationship between ITM dosing and 24-hour postoperative opioid requirement.
KeywordsIntrathecal morphine Neuraxial Anesthesia Spinal Arthroplasty Hip Knee
Compliance with ethical standards
Conflicts of interest
Shane R. Hess, Laura A. Lahaye, Andrew C. Waligora, and Adam P. Sima have no conflicts of interest. William A. Jiranek discloses he is a paid consultant, receives royalties, had has stock with DePuy Synthes, and receives research support from DePuy Synthes and Stryker. Gregory J. Golladay discloses he is a paid consultant for OrthoSensor Inc., receives royalties and research support, has stock, and gives paid presentations for OrthoSensor Inc.; he is the deputy editor for Arthroplasty Today, on the editorial board for Journal of Arthroplasty, and is the publications committee chair for AAHKS.
- 6.Rathmell JP, Pino CA, Taylor R et al (2003) Intrathecal morphine for postoperative analgesia: a randomized, controlled, dose-ranging study after hip and knee arthroplasty. Anesth Analg 97:1452–1457. https://doi.org/10.1213/01.ANE.0000083374.44039.9E CrossRefGoogle Scholar
- 11.Bengtsson M, Lofstrom J, Merits H (1983) Postoperative pain relief with intrathecal morphine after major hip surgery. Reg Anesth 8:140–143Google Scholar
- 15.Goodarzi M, Narasimhan R (2001) The effect of large-dose intrathecal opioids on the autonomic nervous system. Anesth Analg 93:456–459Google Scholar
- 24.Gwirtz KH, Young JV, Byers RS et al (1999) The safety and efficacy of intrathecal opioid analgesia for acute postoperative pain: seven years’ experience with 5969 surgical patients at Indiana University Hospital. Anesth Analg 88:599–604Google Scholar
- 30.Murphy PM, Stack D, Kinirons B, Laffey JG (2003) Optimizing the dose of intrathecal morphine in older patients undergoing hip arthroplasty. Anesth Analg 97:1709–1715. https://doi.org/10.1213/01.ANE.0000089965.75585.0D CrossRefGoogle Scholar