Abstract
IntroductionIntrathecal morphine is widely used for postoperative pain control in major orthopaedic surgery. However, its use is associated with frequent side effects. Aim of the workAim of the work was to investigate the effects of intrathecal coadministration of nalbuphine with intrathecal morphine on morphine related side effects and postoperative analgesic requirements. MethodsIn this study, the intrathecal addition of 1mg nalbuphine hydrochloride to a combination of 3ml hyperbaric bupivacaine 0.5% and 0.2mg morphine sulfate was tried in patients undergoing total knee arthroplasty. ResultsPatients who received intrathecal nalbuphine suffered significantly less than the control group from vomiting and pruritus meanwhile there was no effect on the postoperative analgesic requirements or the incidence of urinary retention. Intrathecal addition of nalbuphine to morphine decreased the opioid related side effects without affection of postoperative analgesia. ConclusionsThe addition of nalbuphine to morphine intrathecally decreases the opioid related side effects without affection of postoperative analgesia. This combination can improve postoperative pain management in patients undergoing knee surgery under spinal anaesthesia.
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