Does Intrathecal Morphine Increase Postop Complications?

TOPLINE:

Use of intrathecal morphine during surgery or labor significantly increases the risk for postoperative nausea and vomiting (PONV), pruritus, and urinary retention, according to a meta-analysis.

METHODOLOGY:

• Researchers reviewed 168 trials involving 9917 patients who underwent various surgeries or labor under general or spinal anesthesia.
• They compared patients who received intrathecal morphine (dose range, 25-4000 µg) with those who received either an injection of normal saline or no injection of any hydrophilic opioid (control).
• Primary outcomes were nausea and vomiting, pruritus, and urinary retention within 24 hours of surgery.

TAKEAWAY:

• Intrathecal morphine significantly increased the rates of PONV (odds ratio [OR], 1.52; P P P = .005).
• No association was found between the dose of morphine and the rates of non-pulmonary complications.

IN PRACTICE:

“We found low-quality evidence that intrathecal morphine significantly increases rates of PONV, pruritus, and urinary retention when all types of surgery and labor are considered,” the authors wrote, adding, “We found no clear evidence of a dose-response relationship.”

SOURCE:

The study was led by Yves Renard, of the Department of Anaesthesia at Lausanne University Hospital and University of Lausanne, in Lausanne, Switzerland. It was published online on August 3, 2024, in the British Journal of Anaesthesia.

LIMITATIONS:

The quality of the evidence was rated as low. The findings may not be generalizable to all surgical settings or patient populations. The heterogeneity across studies and the lack of a dose-response relationship could limit the applicability of the results.

DISCLOSURES:

This work did not receive any external funding. Two authors disclosed financial ties outside this work. Other authors had no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.