Comparison of analgesic effect of intrathecal morphine alone or in combination with bupivacaine and fentanyl in patients undergoing total gastrectomy: A prospective randomized, double blind clinical trial Poreenje analgetskog efekta intratekalno primenjenog morfina samog ili u kombinaciji sa bupivakainom i fentanilom kod bolesnika podvrgnutih totalnoj gastrektomiji - prospektivna, randomizovana, dvostruko slepa klini˛ ka studija

摘要: Background/Aim. Combined spinal-epidural-general anesthesia has several advantages over general alone. This study was designed to compare the efficacy of intrathecal (IT) morphine alone, or in combination with bupivacaine and fentanyl, as part a combined spinal-epidural (CSE) analgesia, patients undergoing elective total gastrectomy. Methods. prospective, randomized double-blind included 60 gastrectomy under CSE. We compared analgesic effect lumbar IT 300 �¨ g (the group M, n = 20) vs + 2 mg MB, fentanyl 25 MBF, given after thoracic epidural catheter placement (T6-7) but before induction. Pain visual analogue scale (VAS) at rest (R), movement (M) cough (C), number analgesia requests were assessed for 72 h removal. Results. Compared other groups, MBF required significantly fewer additional intra-operative doses (p < 0.001), whereas M more supplemental intraoperative intravenous 0.022) MB groups 0.005). Postoperative pain relief satisfactory all time. VAS-R VAS-M did not differ among groups. group, VAS-C scores 30 min postoperatively lower 0.029) 0.002). Duration longer difference reached no significance. The similar first 12 during h. Additional removal side effects infrequent. Conclusion. triple administered CSE provided better conferred benefit regards postoperative analgesia.