The Effects of Locally Administered Morphine Over the Dura on Postoperative Morphine Consumption and Pain After Lumbar Disc Surgery: A Prospective, Randomised, DoubleBlind and Placebo-Controlled Study

Özet

Objective: Effective pain management by avoiding side effects in the perioperative period is essential for patient outcome. Lumbar disc surgeryis associated with moderate to severe postoperative pain, and opioids are widely used. The primary aim of the present study was to compare theeffects of 1 mg and 2 mg morphine-impregnated absorbable cellulose haemostat material placed over the dura on morphine consumption, andthe secondary aims were to compare pain scores and opioid-related side effects during postoperative 24 h.Methods: The study included 44 patients (American Society of Anesthesiologists I and II). After the discectomy procedure and before theclosure, in Group A (n=15), 1 mg morphine-impregnated absorbable cellulose haemostat material placed over the dura was used. In Group B(n=14), 2 mg morphine was used for the same technique, and in Group C (n=15) (control), normal saline was used. All patients used intravenousmorphine patient-controlled analgesia pumps for 24 h following lumbar disc surgery. Morphine consumption, pain scores and opioid-related sideeffects were recorded at 10 min, 1, 2, 6, 12 and 24 h postoperatively.Results: Morphine consumption, pain scores and opioid-related side effects were similar among the groups.Conclusion: Morphine-impregnated absorbable cellulose haemostat material placement over the dura after single level lumbar discectomy didnot reduce postoperative morphine consumption, pain scores and incidence of opioid-related side effects.