Analgesic efficacy of continuous intravenous infusion of morphine in patients after hip and knee joint endoprosthetics: prospective study

Abstract

Objectives of the study was to evaluate the possibility of using and the frequency of side effects of continuous intravenous morphine infusion for patients after arthroplasty of the lower limbs joints. Materials and methods. In the prospective study the results of treatment of 2 groups of patients were compared: after total knee arthroplasty (n = 52) and after total hip arthroplasty (n = 52). The rate of morphine administration in the total knee arthroplasty group ranged from 0.6 to 1.6 mg/hour, in the total knee arthroplasty group it was from 0.4 to 1.4 mg/hour. Continuous infusion of morphine was continued 24 hours after surgery. Indicators of systemic hemodynamics, gas exchange, pain and sedation were recorded. Results. The use of the technique of continuous intravenous infusion of morphine has shown the adequate level of anesthesia. An optimal balance between adequate analgesia, sedation and the absence of respiratory depression can only be achieved through a low rate of morphine administration. There was no significant difference in the incidence of complications and side effects (nausea, vomiting, acute urinary retention, delirium) in the groups with knee and hip arthroplasty. Conclusion. The technique provided, on the one hand, a good analgesic effect and sedation, but on the other hand, it was quite laborious and required careful monitoring of the parameters of the respiratory and cardiovascular systems. It is especially necessary to carefully monitor the indicators of vital functions in the evening and night hours.