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

Overview

STUDY DESIGN: The efficacy of intrathecal (spinal) morphine in the treatment of pain after posterior spinal fusions was assessed. OBJECTIVE: To investigate improved posterior pain control with fewer side effects in patients with posterior spinal fusions. SUMMARY OF BACKGROUND DATA: After multilevel spinal fusion with instrumentation, patients experience considerable pain that is difficult to treat. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.