Reduction in postoperative pain after spinal fusion with instrumentation using intrathecal morphine.

Abstract

The efficacy of intrathecal (spinal) morphine in the treatment of pain after posterior spinal fusions was assessed. To investigate improved posterior pain control with fewer side effects in patients with posterior spinal fusions. After multilevel spinal fusion with instrumentation, patients experience considerable pain that is difficult to treat. For this study, 65 patients undergoing elective multilevel posterior spinal instrumentation were randomized to receive spinal morphine as follows: 10 microgram/kg, 20 microgram/kg, or none. These patients were assessed after surgery for pain control and narcotic-associated complications. The patients who received 20 microgram/kg of spinal morphine were more comfortable immediately after surgery, remained pain free for a longer period, and required significantly less additional narcotic. These patients also had fewer respiratory complications. Relatively high-dose spinal morphine administration provides simple, reliable postoperative pain control after posterior spinal fusions. This may contribute to reduced postoperative respiratory morbidity and an improved outcome.