TITLE:
Analgesic Efficacy of Intrathecal Bupivacaine with or without Morphine in Lower Limb Orthopedic Surgery. A Comparative Study
AUTHORS:
Alexis Dun Bo-ib Buunaaim, Comfort Adubia, Fidelis Bayor, Sylvanus Kampo
KEYWORDS:
Bupivacaine, Morphine, Pain, Analgesia, Orthopedic Surgery
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.13 No.3,
March
30,
2023
ABSTRACT: Background: Lower limb orthopaedic surgeries are commonly associated with moderate to severe postoperative pain. Adequate pain relief is essential for patients undergoing such procedures, as uncontrolled pain can lead to delayed recovery, prolonged hospitalization, and increased morbidity. Intrathecal administration of bupivacaine, a long-acting local anesthetic, has been shown to provide effective analgesia after lower limb orthopaedic surgery. However, the duration of analgesia with bupivacaine alone is limited, and the addition of an opioid, such as morphine, can prolong the duration of analgesia. Objective: The objective of this study was to document the comparative effect of adding morphine to intrathecal bupivacaine or only intrathecal bupivacaine for lower limb trauma orthopedic surgeries in terms of onset of action, duration of analgesia, pain severity, and side effects. Methods: This was a comparative longitudinal study design conducted at the Orthopaedic Unit of the Tamale Teaching Hospital. A simple random sampling technique was used to recruit 60 patients. A standard structured questionnaire was also used to collect data on the socio-demographics, and clinical features of patients, drug used,side effects and severity of pain at 24,48 and 72 hrs after surgery. Results: Co-administration of intrathecal bupivacaine with morphine produced good and long-lasting postoperative analgesia with a mean time of 1004.25 ± 310.43 minutes, whiles using only bupivacaine produced shorter postoperative analgesia with a mean time of 294.75 ± 195.53 minutes. The p-value p values of p = 0.635 and p = 0.689 respectively. Conclusion: The study revealed that co-administration of intrathecal bupivacaine with morphine emerged as a better option for postoperative pain management after lower limb orthopedic surgeries as compared to administering only bupivacaine regarding the duration of analgesia. Milder side effects like pruritus, nausea, and vomiting were seen in group B than in group A and were promptly well managed to the patient’s satisfaction.