Intrathecal morphine analgesia after cervical and thoracic spinal cord tumor surgery

Object. The aim of this study was to provide evidence for the effect of intrathecal morphine application after spinal cord tumor resection. Methods. Twenty patients participated in a prospective open proof-of-concept study. During dural closure, morphine (7 mu g/kg) was injected into the subarachnoid space. All patients were monitored in an intensive care setting postoperatively. Pain, additional opioids given, and vital parameters were recorded. Results. Six patients received a mean morphine dose of 365 mu g between C-3 and C-7 and 14 patients received a mean dose of 436 mu g between T-2 and T-12. In the cervical and thoracic groups, the mean Numeric Rating Scale score was highest upon intensive care unit admision (1.2 and 2.5, respectively) and declined at 12 hours (0.5 and 0.8, respectively). Minimal extra morphine was required. Minor side effects occurred without consequence. Conclusions. Intrathecal morphine for postoperative analgesia after resection of cervical and thoracic spinal cord tumors is effective and safe. These preliminary results require confirmation by larger comparative studies and further clinical experience.