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ISSN 1726-6718 (Electronic)
Revista Cubana de Anestesiología y Reanimación

2018, Number 1

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Revista Cubana de Anestesiología y Reanimación 2018; 17 (1)

Effectiveness of spinal anesthesia with morphine and bupivacaine in prostate surgery

Busto LPI, Montero QN, Hernández PJM

Language: Spanish
References: 20
Page: 1-9
PDF size: 182.75 Kb.


ABSTRACT

Introduction: Postoperative pain is the main cause of acute pain worldwide. Providing adequate analgesia postoperatively guarantees hospital stay reduction and positively affects patient outcome.
Objective: To evaluate the quality of postoperative analgesia with bupivacaine plus intrathecal morphine in elective prostate surgery, as well as the incidence of adverse effects.
Methods: A quasiexperimental research was carried out between January 2014 and July 2017. The sample was chosen in a non-probabilistic way and made up by the patients who gave their informed consent and met the inclusion criteria to enter the study. They were randomly distributed into two groups identified as bupivacaine (B) and morphine-bupivacaine (MB). To collect the information, the anesthetic medical records were used, together with a form prepared for such purpose. The data were shown in charts and graphs, the results were expressed numerically and in percentages, some descriptive measures of interest were determined that showed the behavior of the variables that required it.
Results: The most relevant outcome was the very significant analgesic effect in the MB group in the first 24 hours after surgery. The most common adverse reaction was pruritus and only occurred in the group that received morphine.
Conclusions: Spinal anesthesia with morphine and bupivacaine is effective and safe because it provides better analgesia in the immediate postoperative period in comparison to bupivacaine alone.


REFERENCES

  1. Osado IR. Anestesia intraraquidea. In: Manual de anestesia reginal práctica clínica y tratamiento del dolor. 2da ed. Barcelona: Elsevier; 2014. p. 423-52.

  2. Yaksh TL, Rudy TA. Analgesia mediated by a direct spinal action of narcotics. Science. 1976;192(4246):1357-8.

  3. Hindle A, MB ChB, BSc (Hons), DA, FRCA. Intrathecal opioids in the management of acute postoperative pain. Continuing education in anaesthesia. Critical Care & Pain. 2008 [citado 6 jun 2014];8(3):81-85. Disponible en: https://doi.org/10.1093/bjaceaccp/mkn016

  4. Bernards C. Understanding the physiology and pharmacology of epidural and intrathecal opioids. Best Pract Res Clin Anaesthesiol. 2012;16:(4):489-05.

  5. Velázquez González K, Valdés Llerena R, Pérez Guirola Y. Analgesia postoperatoria en cirugía torácica electiva. Rev cubana Anestesiol Reanim. 2010 [citado 6 jun 2014];9(2):107-18. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1726- 67182010000200006&lng=es

  6. Bernards C. Recent insights into the pharmacokinetics of spinal opioids and the relevance to opioid selection. Curr Opin Anaesthesiol. 2014;17(5):441-7.

  7. Moreira H Jr, Moreira JP, Isaac RR, Alves-Neto O, Moreira TA, Vieira TH, et al. Morphine spinal block anesthesia in patients who undergo an open hemorrhoidectomy: a prospective analysis of pain control and postoperative complications. Annals of Coloproctology. 2014;30(3):135-40.

  8. Fukuda K. Analgésicos opioides. En Miller, RD. Editor. Miller Anestesia. 8va ed. Ed. Madrid: Elsevier; 2016. p. 864-14.

  9. Sherman MJ. Open urologic procedures: Radical cystectomy with diversion, radical prostatectomy and radical nephrectomy anesthetic considerations. En: Traver MA, Darracott Vaughan E, Porter C. Anesthesia for Urologic Surgery. 1ra. New York: Springer; 2014. p.197-14.

  10. Nuri Deniz M, Erhan E, Ugur G. Intrathecal morphine reduces postoperative tramadol consumption in patients undergoing radical retropubic prostatectomy: a randomized trial. Eur Rev Med Pharmacol Sci. 2013;17(6):834-8.

  11. Ozbek H, Deniz MN, Erakgun A, Erhan E. Comparison of 75 and 150 μg doses of intrathecal morphine for postoperative analgesia after transurethral resection of the prostate under spinal anesthesia. J Opioid Management. 2013;9(6):415-20.

  12. Duman A, Apiliogullari S, Balasar M, Gürbüz R, Karcioglu M. Comparison of 50 μg and 25 μg doses of intrathecal morphine on postoperative analgesic requirements in patients undergoing transurethral resection of the prostate with intrathecal anesthesia. J Clinical Anesth. 2010;22(5):329-33.

  13. Pettini E, Micaglio M, Bitossi U, De Gaudio AR, Degl'Innocenti DR, Tofani L, et al. Influence of OPRM1 Polymorphism on Post-operative Pain After Intrathecal Morphine Administration in Italian Patients Undergoing Elective Cesarean Section. Clin J Pain. 2018;34(2):178-181.

  14. Barrington J, Emerson R, Lovald S, Lombardi A, Berend K, Barrington JW, et al. No difference in early analgesia between liposomal bupivacaine injection and intrathecal morphine after TKA. Clinical Orthopaedics & Related Research. 2017;475(1):94-105.

  15. Tomaszewski D, Bałkota M, Truszczyński A, Machowicz A. Intrathecal morphine increases the incidence of urinary retention in orthopaedic patients under spinal anaesthesia. Anaesthesiology Intensive Therapy. 2014;46(1):29-33.

  16. Cruz Diéguez S, Ramos Palacio LY, de la Cruz Sandó I, Campos González M. Analgesia postoperatoria con el uso de morfina liofilizada. Rev Cubana Anestesiol Reanim. 2013 [citado 6 jun 2014];12(2):129-38. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1726- 67182013000200004&lng=es

  17. Slavković Z, Stamenković DM, Gerić V, Veljović M, Ivanović N, Tomić A, et al. Comparison of analgesic effect of intrathecal morphine alone or in combination with bupivacaine and fentanyl in patients undergoing total gastrectomy. Vojnosanit Pregl 2013;70(6):541-57.

  18. Dihle A, Helseth S. Using the american pain society's patient outcome questionnaire to evaluate the quality of postoperative pain management in a sample of norwegian patients. J Pain. 2013;7(4):272-80.

  19. Machado-Alba J, Machado-Duque M, Calderón V, González A, Cardona F, Ruiz R, Montoya J. Control del dolor postquirúrgico en pacientes de un hospital de tercer nivel. Rev Cubana Med. 2013 [citado 12 mar 2014];21(1):46-53. Disponible en: http://www.umng.edu.co/documents/10162/4190548/Capitulo+4.pdf

  20. Gehling M, Tryba M. Risks and side-effects of intrathecal morphine combined with spinal anaesthesia: a meta-analysis. Anaesthesia. 2009;64(6):643-51.




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