Spinal blocks with and without morphine in women undergoing hysterectomies - A randomized study

Abstract

Objective: To study whether a group of patients going through abdominal hysterectomies under general anesthesia could reduce their time of discharge and consumption of parenteral opioids by adding morphine to an intrathecal block. Methods: Sixty seven healthy women, undergoing abdominal hysterectomies. Patients had general anesthesia in combination with spinal blocks. Randomization between intrathecal blocks with morphine (group 1) and without morphine (group 2), in combination with either postoperative intermittent (group 1) or patient controlled analgesia (group 2). Results: The median time to discharge in group 1 was 53 hours and in group two 69 hours. Time of discharge was not statistically significant (p = 0.51). The patients in group 2 had significantly higher visual analogue scores for pain postoperatively. More postoperative opioids were also consumed in that group (p<0.0001). Furthermore, significantly more patients in group 2 compared to group1 indicated that they had suffered from major nausea (p=0.01). Conclusion: In summary, we conclude that intrathecal block with morphine in combination with postoperative nurse administered opioids did not show a difference in time to discharge compared to intratechal block without morphine in combination with PCA. However, there was a significant reduction in the level of pain and nausea as well as consumption of postoperative opioids. Based on the questionnaire, significantly more patients suffered from major nausea in the group without intrathecal morphine.