Comparison of two doses of intrathecal morphine in laparoscopic donor hepatectomy: A randomized double-blinded non-inferiority trial.
Clin Transplant
; 37(8): e14996, 2023 08.
Article
in En
| MEDLINE
| ID: mdl-37076941
ABSTRACT
BACKGROUND:
Intrathecal morphine (ITM) injection is an effective postoperative analgesic strategy in open or laparoscopic donor hepatectomy; however, the optimal dose has not been determined. In this trial, we compared the post-operative analgesic effects of two doses (300 vs. 400 µg) of ITM injections.METHODS:
In this prospective randomized non-inferiority trial, 56 donors were divided into either the 300 µg or 400 µg ITM group (n = 28, each). The primary outcome was the resting pain score at 24 h postoperatively. Pain scores, cumulative opioid consumption, and side effects (postoperative nausea and vomiting [PONV]) were compared up to 48 h postoperatively.RESULTS:
Fifty-five donors participated in the entire study. The mean resting pain scores at 24 h after surgery were 1.7 ± 1.6 and 1.7 ± 1.1 in the ITM 300 and ITM 400 groups, respectively (mean difference, 0 [95% CI, -.8 to .7], p = .978). The upper limit of the 95% CI was lower than the prespecified non-inferiority margin (δ = 1), indicating that non-inferiority had been established. The incidence of PONV was lower in the ITM 300 group than in the ITM 400 group at 18 (p = .035) and 24 h postoperatively (p = .015). There were no significant differences in the resting and coughing pain scores and cumulative opioid consumption at any time point.CONCLUSION:
For laparoscopic donor hepatectomy, preoperative ITM 300 µg exhibited non-inferior postoperative analgesic effects compared to ITM 400 µg, with a lower incidence of PONV.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Analgesics, Opioid
/
Morphine
Type of study:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Year:
2023
Type:
Article