ABSTRACT

Background: Intrathecal morphine is used as post-operative analgesia for total knee replacement surgeries as it is simple to use, not associated with an increase in blood loss during surgery and has a longer duration of action. Objective: To determine the clinical characteristics of intrathecal Morphine in different doses (150 mcg & 200 mcg) when administrated in patients after total knee replacement surgery. Method: The prospective study was carried out at the Care Institute of Medical Science (CIIMS) from April 2022 to March 2023 based on the following inclusion Patients who underwent elective primary unilateral total knee replacement at CIIMS, age: 40-80 years, BMI <40 kg/m2. Exclusion criteria as patients with severe renal or hepatic dysfunction, Contraindication to spinal anaesthesia (refusal, coagulopathy, sepsis, local infection, spinal defects, previous laminectomy), Contraindication to nonsteroidal anti-inflammatory drugs (NSAIDs), Patients with emotional or neurological conditions that would prevent their willingness to participate in the study and Creatinine clearance less than 50 ml/min. Results: A total of 107 patients were included in the study. Further on randomisation 54 received 150 micrograms (group A) of morphine and the other 54 received 200 micrograms (group B) of morphine post-operative. With 200 micrograms the effect of analgesia was longer as compared to 150 micrograms of morphine with fewer side effects. The use of NSAIDs in group A was more as compared to group B (57.4%, 11.1%). Conclusion: We conclude that 200 micrograms of intrathecal morphine is superior to 150 micrograms in total knee replacement surgery. Due to its potential benefits of long lasting analgesic effects and less requirement of other analgesic drugs and it has no major side effects. Keywords: Intrathecal morphine, Knee Replacement Surgeries (TKR), nonsteroidal anti- inflammatory drugs (NSAIDs)
Publication date: 01/08/2025

https://ijbpas.com/pdf/2025/August/MS_IJBPAS_2025_9274.pdf

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https://doi.org/10.31032/IJBPAS/2025/14.8.9274