Why the study?
Does intrathecal morphine improve postoperative pain control in patients undergoing deep hypothermic circulatory arrest during aortic surgery?
Case Report (n=2)
Does intrathecal morphine improve postoperative pain control in patients undergoing deep hypothermic circulatory arrest during aortic surgery?
Intrathecal morphine may provide excellent postoperative analgesia without side effects in patients undergoing aortic surgery with deep hypothermic circulatory arrest.
May support select use in aortic surgery; hypothesis-generating case report leaves open need for RCTs.
We retrospectively report the first use of intrathecal morphine prior to incision in two male patients undergoing a complex aortic reconstruction, who required complete circulatory arrest under deep hypothermia for intraoperative and postoperative pain control. We administered intrathecal morphine to two male patients undergoing circulatory arrest and deep hypothermia. Patients were fully heparinized prior to cardiopulmonary bypass. Deep hypothermic circulatory arrest was performed by cooling the patients to 18℃. Following the surgery, the neurologic status was monitored. The management of postoperative pain is a quality standard in health care. During the first 24 hours after surgery, we observed excellent analgesia without the associated side effects, thus, reducing the time required for pain control by the nursing staff. A successful analgetic strategy not only enhances the patient satisfaction, but may improve the postoperative outcome. However, complications, such as increased risk of epidural hematoma formation, are of special concern in cardiac surgery.
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Przkora et al. (2012) conducted a case report in Complex aortic reconstruction requiring complete circulatory arrest under deep hypothermia (n=2). Intrathecal morphine was evaluated on Postoperative pain control.
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