Morphine Spinal Block Anesthesia in Patients Who Undergo an Open Hemorrhoidectomy: A Prospective Analysis of Pain Control and Postoperative Complications
Jr Helio Moreira, Moreira Jose PT, Isaac Raniere R, Brasil Andressa MS, Alves-Neto Onofre, Moreira Thiago AC, Vieira Tiago HM,
소속 상세정보
( Jr Helio Moreira )
Federal University School of Medicine Department of Surgery Colorectal Service
( Moreira Jose PT )
Federal University School of Medicine Department of Surgery Colorectal Service
( Isaac Raniere R )
Federal University School of Medicine Department of Surgery Colorectal Service
( Brasil Andressa MS )
Federal University School of Medicine Department of Surgery Colorectal Service
( Alves-Neto Onofre )
Federal University School of Medicine Department of Surgery Anesthesiology Service
( Moreira Thiago AC )
Federal University School of Medicine Department of Surgery Anesthesiology Service
( Vieira Tiago HM )
Federal University School of Medicine Department of Surgery Anesthesiology Service
KMID : 0356720140300030135
Abstract
Purpose: This study evaluated the use of adding morphine to bupivacaine in spinal anesthesia for pain control in patients who underwent an open hemorrhoidectomy.
Methods: Forty patients were prospectively selected for an open hemorrhoidectomy at the same institution and were randomized into two groups of 20 patients each: group 1 had a spinal with 7 mg of heavy bupivacaine associated with 80 μg of morphine (0.2 mg/mL). Group 2 had a spinal with 7 mg of heavy bupivacaine associated with distilled water, achieving the same volume of spinal infusion as that of group 1. Both groups were prescribed the same pain control medicine during the postoperative period. Pain scores were evaluated at the anesthetic recovery room and at 3, 6, 12, and 24 hours after surgery. Postoperative complications, including pruritus, nausea, headaches, and urinary retention, were also recorded.
Results: There were no anthropometric statistical differences between the two groups. Pain in the anesthetic recovery room and 3 hours after surgery was similar for both groups. However, pain was better controlled in group 1 at 6 and 12 hours after surgery. Although pain was better controlled for group 1 after 24 hours of surgery, the difference between the groups didn’t achieved statistical significance. Complications were more common in group 1. Six patients (6/20) presented coetaneous pruritus and 3 with (3/20) urinary retention.
Conclusion: A hemorrhoidectomy under a spinal with morphine provides better pain control between 6 and 12 hours after surgery. However, postoperative complications, including cutaneous pruritus (30%) and urinary retention (15%), should be considered as a negative side of this procedure.
키워드
Postoperative pain;Hemorroidectomy;Urinary retention
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