Details

Autor(en) / Beteiligte

• Lena, P.
• Balarac, N.
• Arnulf, J.J.
• Teboul, J.
• Bonnet, F.

Titel

Intrathecal morphine and clonidine for coronary artery bypass grafting

Ist Teil von

• British journal of anaesthesia : BJA, 2003-03, Vol.90 (3), p.300-303

Ort / Verlag

Oxford: Elsevier Ltd

Erscheinungsjahr

2003

Quelle

MEDLINE

Beschreibungen/Notizen

• After cardiac surgery adequate postoperative analgesia is necessary. We assessed analgesia using intrathecal morphine and clonidine. In a double-blind randomized study, 45 patients having coronary artery bypass graft surgery were allocated randomly to receive i.v. patient-controlled analgesia (PCA) morphine (bolus, 1 mg; lock-out interval, 7 min) (control group), either alone or combined with intrathecal morphine 4 μg kg−1 or with both intrathecal morphine 4 μg kg−1 and clonidine 1 μg kg−1. Intrathecal injections were performed before the induction of general anaesthesia. Pain was measured after surgery using a visual analogue scale (VAS). We recorded i.v. PCA morphine consumption during the 24 h after operation. Morphine dosage [median (25th–75th percentiles)] was less in the first 24 h in the patients who were given intrathecal morphine + clonidine [7 (0–37) mg] than in other patients [40.5 (15–61.5) mg in the intrathecal morphine group and 37 (30.5–51) mg in the i.v. morphine group]. VAS scores were lower after intrathecal morphine + clonidine compared with the control group. Time to extubation was less after intrathecal morphine + clonidine compared with the i.v. morphine group [225 (195–330) vs 330 (300–360) min, P<0.05]. Intrathecal morphine and clonidine provide effective analgesia after coronary artery bypass graft surgery and allow earlier extubation.