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Spinal Analgesia with Intrathecal Morphine versus Conventional Analgesia after Laparoscopic Colectomy: A Retrospective Cohort Study

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Open Journal of Anesthesiology 2024年第7期14卷 159-174页

作者： Lionel Diyamona Manon Colin Marc Léone Laurent Zieleskiewicz Joseph Nsiala Wilfrid Mbombo rachel mbala Bruno Pastene Chris Nsituavibidila Dan Kankonde Gracia Likinda Jean Claude Mubenga Khazy Anga Noelly Mukuna Christel Isengingo Department of Anaesthesia and Intensive Care University Clinics of Kinshasa University of Kinshasa Kinshasa Democratic Republic of the Congo Department of Anaesthesia and Intensive Care Marseilles Nord Hospital Marseille France General Hospital of Kinshasa ex Mama Yemo Kinshasa Democratic Republic of the Congo Department of Anaesthesia and Intensive Care Monkole Hospital Centre Kinshasa Democratic Republic of the Congo

Objective: Postoperative pain (POP) following abdominal surgery can vary from a few hours to several days. This acute, unrelieved pain can become chronic, requiring patients to take analgesics on an almost daily basis for comfort. Analgesia using general opioids has many side effects and intrathecal morphine is a good alternative. This study was conducted to evaluate the efficacy of intrathecal morphine (ITM) versus conventional analgesia in the management of postoperative pain in colectomy performed by laparoscopic surgery. Methods: Cohort study conducted at the Hôpital Nord in Marseille, from 01 January to 31 July 2021 in patients aged at least 18 years undergoing anaesthesia for scheduled colectomy by laparoscopic surgery. The primary endpoint was postoperative pain intensity and the secondary endpoints were morphine consumption, treatment side effects and length of hospital stay. Statistical analysis was performed using XLSTAT software. Results: We included 193 patients: 131 in the control group (conventional analgesia) and 62 in the ITM group. We observed: a significant decrease in pain (assessed by numerical scale) in favour of the ITM group in the post-anaesthetic care room, i.e. 3 (±4) vs 1 (±2), p 0 and H2: 2 (±2) vs. 1 (±2);p Conclusion: These results suggest that intrathecal morphine (ITM) in laparoscopic colectomy provides effective postoperative analgesia with low morphine consumption, and a reduction in morphine side-effects compared with conventional analgesia.

关键词： Intrathecal Morphine Colectomy Laparoscopy Conventional Analgesia

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