The Effect of Preoperative, Low-Dose Intrathecal Morphine on Patient Outcomes Following Lumbar Fusion Surgery: Can We Teach an Old Dog New Tricks?

Article Figures & Data

Table 1

Patient demographics.

Abbreviations: ASA, American Society of Anesthesiologists; ITM, intrathecal morphine.
Note: Data are expressed as mean ± SD or n (%).

Table 2

Medication details.

Medication	No ITM (n = 115)	ITM (n = 65)	P
Intraoperative medication
Total intraoperative MME	54.23 ± 35.67	90.29 ± 22.93	<0.001
IV MME (excluding ITM)	54.23 ± 35.67	37.41 ± 19.92	<0.001
ITM	N/A	65 (100)	N/A
ITM, µg	N/A	214.84 ± 35.27	N/A
ITM MME	N/A	53.71 ± 8.82	N/A
Fentanyl	107 (93.0)	60 (92.3)	1
Fentanyl, µg	191.36 ± 130.14	132.50 ± 63.50	<0.001
Morphine	1 (0.9)	17 (26.2)	<0.001
Morphine, mg	2.00 ± 0	5.83 ± 2.73	<0.001
Hydromorphone	83 (72.2)	20 (30.8)	<0.001
Hydromorphone, mg	1.32 ± 0.85	0.91 ± 0.61	0.015
Fluid received, mL	2547.2 ± 1415.8	2349.2 ± 1107.5	0.302
Postoperative medication
Total PACU MME	21.83 ± 21.07	9.7 ± 31.23	0.006
Total floor MME	110.24 ± 139.92	88.0 ± 84.51	0.186
Total floor + PACU MME	132.07 ± 144.18	97.73 ± 91.04	0.052
Postoperative day 0 floor MME	13.64 ± 15.63	8.86 ± 13.55	0.033
Postoperative day 0 floor + PACU MME	35.47 ± 28.51	18.60 ± 35.47	0.001
Postoperative day 1 floor MME	35.19 ± 30.88	33.05 ± 28.33	0.638
Postoperative day 2 floor MME	21.41 ± 34.74	23.89 ± 27.54	0.599

Abbreviations: ITM, intrathecal morphine; IV, intravenous; ML, milliliter; MME, milligram morphine equivalent; PACU, postanesthesia care unit.
Note: P values < 0.05 in bold. Data are expressed as mean ± SD or n (%).

Table 3

Maximum Pain scores.

Abbreviations: ITM, intrathecal morphine; PACU, postanesthesia care unit; POD, postoperative day.
Note: P values < 0.05 in bold. Data are expressed as mean ± SD or n (%).

Table 4

Adverse events.

Table 5

Postoperative outcomes.

Abbreviations: DVT, deep vein thrombosis; ED, emergency department; ITM, intrathecal morphine; OR, operating room.
Note: P values < 0.05 in bold. Data are expressed as mean ± SD or n (%).