Abstract
Background: To assess the safety and efficacy of intrathecal diamorphine for the postoperative pain relief in patients having lumbar decompressive surgery.
Methods: Retrospective study of case records of 39 consecutive patients who underwent lumbar decompression surgery, carried out by the same surgeon. There were 39 (24 males & 15 females, age range 19–75 years) healthy patients (23 ASA 1, 13 ASA 2 and 3 ASA 3). All patients having lumbar microdiscetomy or decompression for spinal stenosis were treated by a single intrathecal injection of diamrphine, performed by the surgeon prior to wound closure. All were prescribed regular paracetamol, and a NSAID if there were no contraindications. Oral opiates were prescribed for “rescue” analgesia. Retrospective analysis of the case notes of these patients was carried out and visual analogue pain scores, sedation scores and side effects/complications were evaluated.
Results: Five patients required rescue analgesia in the first six hours after surgery. None was required subsequenty. Nausea occurred in 2 patients, 1 patient had vomiting and one pruritus requiring piriton. Respiratory depression and sedation were not found in any of the patients. None of the patients had neurological complications.
Conclusion: Intrathecal diamorphine proved to be safe, effective and eliminated the need for opioid infusions following lumbar decompression surgery.
The abstracts were prepared by Mr Colin E. Bruce. Correspondence should be addressed to Colin E. Bruce, Consultant Orthopaedic Surgeon, Alder Hey Children’s Hospital, Eaton Road, Liverpool, L12 2AP.
References:
1 Boezaart AP, Eksteen JA, Spuy GV, et al. Intrathecal morphine: double-blind evaluation of optimal dosage for analgesia after major lumbar spinal surgery. Spine1999;24:1131–7. Google Scholar
2 France JC, Jorgenson SS, Lowe TG, et al. The use of intrathecal morphine for analgesia after posterolateral lumbar fusion: a prospective, double-blind, randomized study. Spine1997;22:2272–7. Google Scholar
