Key result
Intrathecal administration of 200 μg of morphine reduced the median duration of mechanical ventilation from 300 to 200 minutes compared to standard anesthesia in patients undergoing elective cardiac surgery.
Why the study?
Previous studies on intrathecal morphine for optimizing postoperative analgesia and reducing mechanical ventilation duration in cardiac surgery showed conflicting results.
Does intrathecal morphine 200 μg reduce mechanical ventilation duration and improve postoperative analgesia in adults undergoing elective cardiac surgery with cardiopulmonary bypass?
RCT (n=42)
Randomized
No
Does intrathecal morphine 200 μg reduce mechanical ventilation duration and improve postoperative analgesia in adults undergoing elective cardiac surgery with cardiopulmonary bypass?
Absolute Event Rate: 200% vs 300%
p-value: p=0.017
Intrathecal morphine 200 μg combined with general anesthesia reduces mechanical ventilation time and improves postoperative analgesia in patients undergoing elective cardiac surgery.
Supports intrathecal morphine 200 μg to shorten ventilation and improve analgesia after cardiac surgery; extends RCT evidence for neuraxial opioids in this setting.
BACKGROUND: The use of intrathecal morphine in cardiac surgery has the potential to enhance postoperative course. Previous studies on the use of intrathecal morphine for optimizing postoperative analgesia and reducing the duration of mechanical ventilation (MV) have shown conflicting results, indicating the need for further clarification. AIM: To compare the effects of intrathecal morphine at a dose of 200 μg on postoperative course in patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB). METHODS: This prospective single-center study enrolled 42 patients aged 18 years. Patients were divided into two groups: group 1 received anesthesia with sevoflurane and fentanyl; group 2 received intrathecal morphine (200 μg) 60 min prior to induction of general anesthesia. All patients underwent elective cardiac surgery with CPB. Postoperative parameters included acid–base status, blood gas changes, glycemia, extubation time, pain scores, complication rates, and mortality. RESULTS: Intrathecal morphine administration resulted in a statistically significant reduction in the duration of MV from 300 (247; 435) to 200 (150; 360) min (p=0.017), a decrease in pain intensity by 2.1 points at 6 h postoperatively and by 1.7 points at 18–24 h postoperatively, as well as a reduced need for intravenous morphine administration during the first 24 h after surgery. The number needed to treat was 1.67. CONCLUSION: The combination of general multicomponent anesthesia with intrathecal morphine contributes to a reduction in MV time, improves the quality of postoperative analgesia, and decreases the need for intravenous opioid administration in cardiac surgery patients.
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Silanau et al. (2025) conducted an RCT in Elective cardiac surgery with cardiopulmonary bypass (n=42). Intrathecal morphine vs. General anesthesia with sevoflurane and fentanyl was evaluated on Duration of mechanical ventilation (minutes) (p=0.017). Intrathecal administration of 200 μg of morphine reduced the median duration of mechanical ventilation from 300 to 200 minutes compared to standard anesthesia in patients undergoing elective cardiac surgery.
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