The Efficacy of Intrathecal Morphine with Bupivacaine for Postoperative Analgesia After TUR-B

Abstract

Objective: In this randomized study, we evaluated two different doses of intrathecal (IT) morphine with bupivacainefor analgesia after transurethral resection of bladder (TUR-B).Material and Method: Seventy-five patients were randomly divided into three groups. They were allocated to receiveIT morphine (100 µg) with 12.5 mg 0.5% bupivacaine (Group 1), IT morphine (200 µg) with 12.5 mg 0.5%bupivacaine (Group 2), and IT 12.5 mg 0.5% bupivacaine without morphine (Group 3). Postoperative pain wasevaluated by VAS during 24 h and each patient was given intravenous paracetamol and Dexketoprophen trometamolif pain severity was moderate.Results: VAS scores were significantly lower in Groups I and II than Group III at 1h, 2h, 4h, 6h, 12h (p< 0.05) (Figure1). The request for analgesia was significantly higher in Group III than the other two groups (p< 0.05). More patientsreported postoperative nausea in Group II than the other two groups (p< 0.05) (Figure 2).Conclusion: IT morphine (100 µg and 200 µg) with 12.5 mg 0.5% provided a significant reduction in postoperativepain scores compared to IT 12.5 mg 0.5% bupivacaine alone. IT morphine 100 µg provided comparable postoperativepain control with significantly lower side effects than IT morphine 200 µg after TUR-B.