Intrathekal verabreichtes Morphin bei orthopädischen Eingriffen

Abstract

In orthopaedic patients with dipyrone as the primary analgesic, the addition of 0.1 mg or 0.2 mg morphine to spinal anaesthesia provided a simple long-lasting postoperative analgesia and the use of additional opioids could be avoided during the 24h postoperative period.

Efficacy and safety of intrathecal morphine for analgesia after lower joint arthroplasty: a systematic review and meta‐analysis with meta‐regression and trial sequential analysis

“…We identified 1198 trials, with 29 different trials published in 29 distinct manuscripts, including a total of 1814 patients, meeting the inclusion criteria [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ] (see also Supporting Information Fig. S1).…”

“…Table 1 shows the trial characteristics. In eight and 14 trials, authors included patients undergoing hip [ 25 , 32 , 36 , 37 , 41 , 42 , 44 , 53 ] or knee arthroplasty [ 26 , 27 , 28 , 29 , 38 , 39 , 40 , 43 , 46 , 47 , 49 , 50 , 51 , 52 ], respectively, while seven trials included both [ 30 , 31 , 33 , 34 , 35 , 45 , 48 ]. One trial presented separate results for hip and knee arthroplasties [ 48 ].…”

“…Most trials used bupivacaine for spinal anaesthesia, except in three studies where levobupivacaine [ 51 ] or tetracaine [ 30 , 48 ] were administered. Intrathecal morphine doses ranged from 35 µg [ 51 ] to 500 µg [ 30 , 36 , 37 ], while the most frequently investigated dose was 100 µg [ 25 , 27 , 31 , 32 , 33 , 34 , 35 , 38 , 40 , 42 , 43 , 44 , 47 , 48 ]. Eight trials allocated patients to different intervention groups with different intrathecal doses of morphine [ 31 , 34 , 35 , 38 , 40 , 44 , 47 , 48 ].…”

“…Intrathecal morphine doses ranged from 35 µg [ 51 ] to 500 µg [ 30 , 36 , 37 ], while the most frequently investigated dose was 100 µg [ 25 , 27 , 31 , 32 , 33 , 34 , 35 , 38 , 40 , 42 , 43 , 44 , 47 , 48 ]. Eight trials allocated patients to different intervention groups with different intrathecal doses of morphine [ 31 , 34 , 35 , 38 , 40 , 44 , 47 , 48 ]. Among patients undergoing hip arthroplasty, local anaesthesia infiltration analgesia was used in one study [ 25 ].…”

“…We identified 1198 trials, with 29 different trials published in 29 distinct manuscripts, including a total of 1814 patients, meeting the inclusion criteria [25–53] (see also Supporting Information Fig. S1).…”