Comparison of Intrathecal Morphine and Fentanyl in Postoperative Pain Management of Spine Surgeries: A Randomized Double-blind Clinical Trial
Background and Aim: This study aims to compare the effectiveness of intrathecal morphine andfentanyl in reducing postoperative pain in patients undergoing spinal surgery.Methods and Materials/Patients: This was a randomized, double-blind clinical trial involving 80patients who were candidates for sp...
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Guilan University of Medical Sciences
2025-01-01
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| Series: | Iranian Journal of Neurosurgery |
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| Online Access: | http://irjns.org/article-1-425-en.pdf |
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| author | Ehsan Parsa Mehran Ilaghi Hamed Reihani-Kermani |
| author_facet | Ehsan Parsa Mehran Ilaghi Hamed Reihani-Kermani |
| author_sort | Ehsan Parsa |
| collection | DOAJ |
| description | Background and Aim: This study aims to compare the effectiveness of intrathecal morphine andfentanyl in reducing postoperative pain in patients undergoing spinal surgery.Methods and Materials/Patients: This was a randomized, double-blind clinical trial involving 80patients who were candidates for spinal surgery. The participants were randomly assigned totwo groups (n=40 each) and received either intrathecal morphine (0.2 mg) or fentanyl (25 µg). Postoperative pain was evaluated utilizing the visual analogue scale (VAS) at 4, 6, 12, and 18 h postsurgery. The time interval before a supplementary analgesic dose was required for pain control was recorded. Side effects, including pruritus, nausea/vomiting, and respiratory depression were monitored.
Results: No significant differences were observed in age, sex, or operation type between the two groups. Patients in the morphine group exhibited remarkably lower VAS scores at all the assessed postoperative time points (P=0.001). Moreover, patients in the morphine group showed significantly lower overall mean VAS scores than those in the fentanyl group (3.75; 95% confidence interval [CI], 3.53%, 3.97% vs 5.06; 95% CI, 4.85%, 5.27%; P<0.001). The time to analgesic administration was significantly longer in the morphine group compared to the fentanyl group(P=0.001). The occurrence of postoperative nausea and vomiting was significantly higher in the morphine group (37.5%) than in the fentanyl group (15.0%, P=0.022). The incidence of pruritus did not differ significantly between the two groups. No cases of respiratory depression have been reported.
Conclusion: Intrathecal morphine was more effective in reducing postoperative pain and prolonging the time to rescue analgesic administration compared to intrathecal fentanyl in patients undergoing spine surgeries. However, a higher incidence of postoperative nausea/vomiting should be considered. |
| format | Article |
| id | doaj-art-28c1b8d9c0164f09a25c4e05ba509a50 |
| institution | OA Journals |
| issn | 2423-6497 2423-6829 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Guilan University of Medical Sciences |
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| series | Iranian Journal of Neurosurgery |
| spelling | doaj-art-28c1b8d9c0164f09a25c4e05ba509a502025-08-20T02:17:04ZengGuilan University of Medical SciencesIranian Journal of Neurosurgery2423-64972423-68292025-01-0111Continuous Publishing19Comparison of Intrathecal Morphine and Fentanyl in Postoperative Pain Management of Spine Surgeries: A Randomized Double-blind Clinical TrialEhsan Parsa0Mehran Ilaghi1Hamed Reihani-Kermani2 Department of Neurosurgery, Kerman University of Medical Sciences, Kerman, Iran. Kerman Neuroscience Research Center, Institute of Neuropharmacology, Kerman, Iran. Department of Neurosurgery, Kerman University of Medical Sciences, Kerman, Iran. Background and Aim: This study aims to compare the effectiveness of intrathecal morphine andfentanyl in reducing postoperative pain in patients undergoing spinal surgery.Methods and Materials/Patients: This was a randomized, double-blind clinical trial involving 80patients who were candidates for spinal surgery. The participants were randomly assigned totwo groups (n=40 each) and received either intrathecal morphine (0.2 mg) or fentanyl (25 µg). Postoperative pain was evaluated utilizing the visual analogue scale (VAS) at 4, 6, 12, and 18 h postsurgery. The time interval before a supplementary analgesic dose was required for pain control was recorded. Side effects, including pruritus, nausea/vomiting, and respiratory depression were monitored. Results: No significant differences were observed in age, sex, or operation type between the two groups. Patients in the morphine group exhibited remarkably lower VAS scores at all the assessed postoperative time points (P=0.001). Moreover, patients in the morphine group showed significantly lower overall mean VAS scores than those in the fentanyl group (3.75; 95% confidence interval [CI], 3.53%, 3.97% vs 5.06; 95% CI, 4.85%, 5.27%; P<0.001). The time to analgesic administration was significantly longer in the morphine group compared to the fentanyl group(P=0.001). The occurrence of postoperative nausea and vomiting was significantly higher in the morphine group (37.5%) than in the fentanyl group (15.0%, P=0.022). The incidence of pruritus did not differ significantly between the two groups. No cases of respiratory depression have been reported. Conclusion: Intrathecal morphine was more effective in reducing postoperative pain and prolonging the time to rescue analgesic administration compared to intrathecal fentanyl in patients undergoing spine surgeries. However, a higher incidence of postoperative nausea/vomiting should be considered.http://irjns.org/article-1-425-en.pdfspine surgerypostoperative painintrathecal morphineintrathecal fentanyl |
| spellingShingle | Ehsan Parsa Mehran Ilaghi Hamed Reihani-Kermani Comparison of Intrathecal Morphine and Fentanyl in Postoperative Pain Management of Spine Surgeries: A Randomized Double-blind Clinical Trial Iranian Journal of Neurosurgery spine surgery postoperative pain intrathecal morphine intrathecal fentanyl |
| title | Comparison of Intrathecal Morphine and Fentanyl in Postoperative Pain Management of Spine Surgeries: A Randomized Double-blind Clinical Trial |
| title_full | Comparison of Intrathecal Morphine and Fentanyl in Postoperative Pain Management of Spine Surgeries: A Randomized Double-blind Clinical Trial |
| title_fullStr | Comparison of Intrathecal Morphine and Fentanyl in Postoperative Pain Management of Spine Surgeries: A Randomized Double-blind Clinical Trial |
| title_full_unstemmed | Comparison of Intrathecal Morphine and Fentanyl in Postoperative Pain Management of Spine Surgeries: A Randomized Double-blind Clinical Trial |
| title_short | Comparison of Intrathecal Morphine and Fentanyl in Postoperative Pain Management of Spine Surgeries: A Randomized Double-blind Clinical Trial |
| title_sort | comparison of intrathecal morphine and fentanyl in postoperative pain management of spine surgeries a randomized double blind clinical trial |
| topic | spine surgery postoperative pain intrathecal morphine intrathecal fentanyl |
| url | http://irjns.org/article-1-425-en.pdf |
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