The effect of adding morphine to intratecal bupivacaine on postoperative analgesia in patients with perianal surgery

Abstract

Aim: Pain is the major problem in early postoperative period after anorectal operations. In this study, we aimed to evaluate the first analgesic requirement time and complications of intrathecal 5 mg hyperbaric bupivacaine, intrathecal 5 mg hyperbaric bupivacaine with intrathecal 50 μg and 100 μg of morphine combinations in anorectal surgery. Material and Method: A total of 60 patients divided into 3 groups, including 20 patients in each group, were included for the study;Group 1: 5 mg 0.5% heavy bupivacaine (HB), Group 2: 5 mg 0.5% HB and 50 μg Morphine,Group 3: 5 mg 0.5% HB and 100 μg Morphine was intrathecally administered. Intraoperative and postoperative hemodynamics, time to urination and first analgesia requirement, perioperative and postoperative side effects were recorded Results: The time to first analgesic requirement in Group 1 (305.40±143.86) was statistically significantly lower than Group 2 (435.50±171.70) and Group 3 (435.50±156.08) (p=0.015). No significant difference was found between urinary retention (p>0.05). It was determined that the postoperative nausea and vomiting percentages (25.0%) in Group 3 were statistically significantly higher than Group 2 (5.0%) and Group 1 (0.0%) (p<0.05). Conclusions: The use of 50 μg of intrathecal morphine in patients undergoing anorectal surgery in saddle block anesthesia has the expected effect on postoperative analgesia and for this reason it is considered appropriate to be preferred in anorectal surgery thus to the minimal adverse side effects.