Management of postoperative pain is a central piece in the jigsaw of postoperative care. This article reports a series of three patients who were managed with intrathecal morphine to provide postoperative analgesia, for major abdominal surgeries. Morphine was injected intrathecally before the induction of anaesthesia. The patients were pain free postoperatively, required minimal intravenous opioids on the first postoperative day. There was no incidence of postoperative nausea or vomiting, pruritus and respiratory depression. Intrathecal morphine improves the quality of postoperative analgesia, there is a reduction in pain scores in the first 24 hours after surgery and the need for rescue analgesia with intravenous opioids is less. Intrathecal morphine can be used as an alternative to continuous epidural analgesia in early postoperative period.

We report a case which was managed by spinal anaesthesia using Taylor's approach. The patient had an altered spine anatomy due to previous L4-L5 laminectomy and discectomy with L4, L5, S1 transpedicular fixation and fusion. Patient's history of post-operative confusion and apprehension about general anaesthesia (GA) made spinal anaesthesia our first choice. However, in view of the altered spine anatomy, Taylor's approach was used successfully to manage anaesthesia to avoid GA. Conclusion: Although SAB is a relative contraindication for patient with history of previous spine surgery mostly due to altered spine anatomy, SAB can be safely administered via Taylor's approach when general anaesthesia has to be avoided.