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- W2085947633 abstract "The purpose of this study was to compare an intrathecal fentanyl infusion with intrathecal morphine infusion or bolus for postoperative pain relief after hip arthroplasty. Sixty patients scheduled to undergo hip joint replacement were studied. A 28-gauge (n = 12) or a 22-gauge (n = 48) spinal catheter was introduced through the L3–4 interspace, 3--4 cm into the subarach-noid space. Spinal anesthesia was induced with 2 mL of plain 0.5% bupivacaine; additional bupivacaine was given in 0.5-mL increments, as required. Patients were given in a random and double-blind fashion either 0.5 mL of saline as a single bolus, followed by an infusion of 120 pg of fentanyl in 24 h (Group I, n = 20), 0.5 mL of saline, followed by an infusion of 200 μg of morphine in 24 h (Group II, >n = 20), or 200 μg of morphine as a single bolus, followed by an infusion of 3 mL of saline in 24 h (Group III, n = 20) through the intrathecal catheter. In Group I, supplementary intramuscular (IM) opioid was required more often (46 doses) than in Group II (18 doses) in 24 h (P < 0.01). The number of patients given IM administered opioid was larger in Group I (18 patients) than in Group II (8 patients) (P < 0.01). The IM opioid was requested sooner in Group I (18 patients, mean 480 min) after the intrathecal injection than in Group III (13 patients, mean 786 min) (P < 0.01). In Group III, 13 patients required urinary bladder catheterization as compared to 6 patients in Group I (P < 0.05) and II in Group II. Nausea and pruritus occurred equally often in all three groups. We conclude that intrathecal infusion of fentanyl at 5 μg/h, instituted together with bupivacaine spinal block, was inadequate for postoperative analgesia after hip surgery in elderly patients. Intrathecal morphine (200 μg) as a single dose or as a continuous infusion provided better analgesia, and the quality of analgesia after the two modes of administration was similar for the first 18 h." @default.
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- W2085947633 date "1993-07-01" @default.
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- W2085947633 title "Comparison of Intrathecal Fentanyl Infusion with Intrathecal Morphine Infusion or Bolus for Postoperative Pain Relief After Hip Arthroplasty" @default.
- W2085947633 doi "https://doi.org/10.1213/00000539-199307000-00025" @default.
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