doiSerbia

Efficiency and safety of intrathecal morphine for analgesia after hysterectomy

Tatić Milanka (University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia)
Lađinović Dragan (Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia)
Skeledžija-Mišković Sanja (Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia)
Zdravković Ranko (Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia)
Radovanović Dragana (University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia)
Vicko Ferenc (University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia)
Malenković Goran (University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia)
Vučković-Karan Jelena (Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia)
Uvelin Arsen (University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Clinical Center of Vojvodina, Emergency Center, Novi Sad, Serbia)

Introduction/Objective. This prospective, randomized study was done to determine the efficiency and safety of the administration of intrathecal morphine chloride combined with the local anesthetic levobupivacaine given to female patients subjected to hysterectomy to ensure postoperative analgesia. Methods. The study sample consisted of 50 patients who were to undergo hysterectomy with adnexectomy and they were divided into two groups of 25 each. The patients in group A were given the combination of 0.3 mg of morphine chloride with 1.7 ml of 0.5% levobupivacaine immediately before the surgery, whereas the patients in group B were intravenously administered 5 mg of morphine chloride before the end of surgery, and after the surgery at certain time intervals. The postoperative pain was assessed at the first, sixth, 12th, and 24th hour by Numeric Rating Scale (NRS). Side effects, such as nausea, vomiting, itching and respiratory depressions were followed as well. Results. The postoperative pain was less expressed at any time interval both at rest and on exertion in group A (p < 0.001) and therefore the need for additional analgesia was less in group A (p < 0.001). The subjective feeling of satisfaction with postoperative analgesia was statistically significant in group A (p < 0.001). Conclusion. Intrathecal administration of morphine chloride combined with levobupivacaine ensures better postoperative analgesia after hysterectomy than intravenous morphine chloride, their side effects being equally frequent..

Keywords: Hysterectomy, intrathecal morphine, postoperative analgesia