Role of Intrathecal Morphine for Acute Postoperative Pain Management in Patients Undergoing Kidney Transplant: A Randomized Controlled Study.

OBJECTIVES

Postoperative pain after a major surgery continues to be a challenge. Regional anesthetic techniques make up a substantial part of interventions to decrease postoperative pain and the use of opioids. In this study, we aimed to evaluate the effectiveness of intrathecal morphine in patients undergoing kidney transplant, in terms of both duration and quality of postoperative analgesia.

MATERIALS AND METHODS

We conducted a prospective randomized double-blind study and analyzed 60 patients divided into 2 groups of 30 each who were scheduled for elective living-related (first-degree donor) kidney transplant. One group received intrathecal morphine, and the other group received intrathecal normal saline. We used the numeric rating scale to assess the postoperative pain score. We also recorded the postoperative consumption of fentanyl, time of first analgesia requirement, total rescue analgesia, catheter-related bladder discomfort, and related complications for 48 hours postoperatively.

RESULTS

Patients in the intrathecal morphine group had significantly lower pain scores both at rest and while coughing and less consumption of total fentanyl (P < .05). When we compared patient groups, patients in the intrathecal morphine group had significantly lower total rescue analgesia (P < .05) and significantly lower catheter-related bladder discomfort but significantly higher pruritus (P = .01).

CONCLUSIONS

Intrathecal morphine significantly reduces postoperative opioid consumption and can result in fewer incidences of catheter-related bladder discomfort.