Analgesic Effect of Intrathecal Morphine for Postoperative Analgesia in Cytoreductive Surgery in Comparison with Placebo Control: A Randomnised Controlled Trial
Authors/Creators
- 1. Fellow Dept. of Oncoanaesthesia and Critical Care, State Cancer Institute, Gauhati Medical College
- 2. Professor, Department of Onco anaesthesia and Critical Care, State Cancer Institute, GMCH
- 3. Assistant professor, department of Oncoanaesthesia and Critical Care, GMCH
- 4. Senior Resident, Department of Oncoanaesthesia and Critical Care
Description
Abstract
A hospital based open label observational study was conducted in the department of Onco anaesthesia and critical
care, State cancer institute, GMCH to observe the post-operative analgesia after Cytoreductive Surgeries in
patients receiving intrathecal morphine.
Ethical clearance was obtained from the institutional ethics committee prior to commencement of the trial. Based
on the selection criteria, 40 patients were selected of ASA 2 scheduled for Cytoreductive Surgeries and were
divided into 2 groups of 20 patients each.
Group ITM received 300 mcg of intrathecal morphine along with standard anaesthetic care while placebo control
group received the standard anaesthetic care. Injection Fentanyl 2mcg/kg was used in both the groups at the time
of induction and Infusion Paracetamol 1gm was used intraoperatively in both the groups. Inf Paracetamol was
also used postoperatively 12 hourly in both the groups.
The parameters used in this study were age, weight, heart rate, SBP, DBP, MAP, VAS score for 48 hours. Time
of first rescue analgesia.
Analgesic consumption in the first 24 hours, analgesic consumption in the next 48 hours and side effects.
In our study the demographic profile such as age, weight, ASA physical status were comparable in both groups
and were statistically insignificant.
In our study the hemodynamic status was assessed in terms of heart rate, systolic blood pressure (SBP), diastolic
blood pressure(DBP) and mean arterial pressure (MAP).
There was no statistically significant variation in the hemodynamic status in both the groups (p>.05).
There was statistically significant difference (p<.05) in favor of ITM with respect to VAS for most part of our
study.
There was statistically significant difference in the use of rescue analgesic immediately after the postoperative
period at 2hours postoperatively.
1 patient in ITM group (Group1) needed first rescue analgesia at 2nd hour whereas 19 patients needed in Placebo
group (Group2) which was statistically significant p-value <0.0001.
It was observed that total analgesic consumption in group 1 was 46 and in group 2 was 114 in 48 hours. Total
analgesic consumption in first 24 hours in group1 was 30 whereas in group 2 it was 87 which was statistically
significant.
There was no significant adverse effect in both the groups.
Total ICU stay in both the groups were comparable and was not statistically significant
Abstract (English)
Abstract
A hospital based open label observational study was conducted in the department of Onco anaesthesia and critical
care, State cancer institute, GMCH to observe the post-operative analgesia after Cytoreductive Surgeries in
patients receiving intrathecal morphine.
Ethical clearance was obtained from the institutional ethics committee prior to commencement of the trial. Based
on the selection criteria, 40 patients were selected of ASA 2 scheduled for Cytoreductive Surgeries and were
divided into 2 groups of 20 patients each.
Group ITM received 300 mcg of intrathecal morphine along with standard anaesthetic care while placebo control
group received the standard anaesthetic care. Injection Fentanyl 2mcg/kg was used in both the groups at the time
of induction and Infusion Paracetamol 1gm was used intraoperatively in both the groups. Inf Paracetamol was
also used postoperatively 12 hourly in both the groups.
The parameters used in this study were age, weight, heart rate, SBP, DBP, MAP, VAS score for 48 hours. Time
of first rescue analgesia.
Analgesic consumption in the first 24 hours, analgesic consumption in the next 48 hours and side effects.
In our study the demographic profile such as age, weight, ASA physical status were comparable in both groups
and were statistically insignificant.
In our study the hemodynamic status was assessed in terms of heart rate, systolic blood pressure (SBP), diastolic
blood pressure(DBP) and mean arterial pressure (MAP).
There was no statistically significant variation in the hemodynamic status in both the groups (p>.05).
There was statistically significant difference (p<.05) in favor of ITM with respect to VAS for most part of our
study.
There was statistically significant difference in the use of rescue analgesic immediately after the postoperative
period at 2hours postoperatively.
1 patient in ITM group (Group1) needed first rescue analgesia at 2nd hour whereas 19 patients needed in Placebo
group (Group2) which was statistically significant p-value <0.0001.
It was observed that total analgesic consumption in group 1 was 46 and in group 2 was 114 in 48 hours. Total
analgesic consumption in first 24 hours in group1 was 30 whereas in group 2 it was 87 which was statistically
significant.
There was no significant adverse effect in both the groups.
Total ICU stay in both the groups were comparable and was not statistically significant
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