European review for medical and pharmacological sciences

Intrathecal morphine reduces postoperative tramadol consumption in patients undergoing radical retropubic prostatectomy: a randomized trial.

PMID 23609368


Intrathecal (IT) morphine provides prolonged analgesia after major surgery. The aim of our study was to assess the impact of intrathecal morphine 200 µg on patient-controlled analgesia (PCA) tramadol consumptions and postoperative pain in patients who underwent radical retropubic prostatectomy (RRP) under general anesthesia. In this prospective trial, 56 men who underwent radical retropubic prostatectomy (RRP) were randomized into 2 groups. Group M received intrathecal morphine (200 µg) before the induction of general anesthesia. Group C did not receive intrathecal morphine. Postoperative analgesia was provided with tramadol PCA. Pain scores, tramadol consumption, adverse effects, rescue analgesia were recorded. Total tramadol consumption at 24 hours and pain scores during 12 hours postoperatively were significantly lower in Group M compared with Group C (p < 0.05). Rescue analgesia and postoperative nausea were lower in Group M than in Group C (p < 0.05). Intrathecal morphine 200 µg provided a significant reduction in tramadol consumption, postoperative pain scores, rescue analgesia, and postoperative nausea after RRP without serious adverse effects.