Comparison of 50 microg and 25 microg doses of intrathecal morphine on postoperative analgesic requirements in patients undergoing transurethral resection of the prostate with intrathecal anesthesia

J Clin Anesth. 2010 Aug;22(5):329-33. doi: 10.1016/j.jclinane.2009.09.006.

Abstract

Study objective: To compare the efficacy of 50 mug and 25 mug doses of intrathecal morphine on postoperative pain in patients undergoing transurethral resection of the prostate (TURP) with low-dose bupivacaine.

Design: Randomized, double-blinded study.

Setting: Konya Hospital.

Patients: 70 ASA physical status I, II, and III patients.

Interventions: Patients were randomized to two groups: Group A patients received 5 mg of 0.5% hyperbaric bupivacaine (one mL) and 50 mug of morphine (0.5 mL). Group B patients received 5 mg of 0.5% hyperbaric bupivacaine (one mL) and 25 mug of morphine (0.5 mL).

Measurements: Postoperative pain scores, patient and surgeon satisfaction, and side effects such as emesis, pruritus, and respiratory depression, were recorded.

Main results: Postoperative pain characteristics were similar between the two groups. Frequency of emesis was similar between the groups, while pruritus was significantly higher in Group A. No antipruritic medication was required in any patient. Patient and surgeon satisfaction was evaluated as good or excellent in both groups.

Conclusions: Intrathecal morphine at a dose of 25 mug provides similar postoperative analgesia and less pruritus than the 50 mug dose in patients undergoing TURP.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / therapeutic use
  • Bupivacaine / administration & dosage
  • Bupivacaine / therapeutic use
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Humans
  • Injections, Spinal
  • Male
  • Middle Aged
  • Morphine / administration & dosage*
  • Morphine / adverse effects
  • Morphine / therapeutic use
  • Pain, Postoperative / prevention & control
  • Patient Satisfaction
  • Prospective Studies
  • Transurethral Resection of Prostate / methods*
  • Vomiting / chemically induced

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Morphine
  • Bupivacaine