Intrathecal morphine in two patients undergoing deep hypothermic circulatory arrest during aortic surgery: A case report.
10.4097/kjae.2012.63.6.563
- Author:
Rene PRZKORA
1
;
Tomas D MARTIN
;
Philip J HESS
;
Rama S KULKARNI
Author Information
1. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
- Publication Type:Case Report
- Keywords:
Cardiac surgical procedures;
Circulatory arrest (hypothermia induced);
Morphine;
Spinal anesthesia
- MeSH:
Analgesia;
Anesthesia, Spinal;
Cardiac Surgical Procedures;
Cardiopulmonary Bypass;
Circulatory Arrest, Deep Hypothermia Induced;
Delivery of Health Care;
Hematoma;
Heparin;
Humans;
Hypothermia;
Male;
Morphine;
Nursing Staff;
Pain, Postoperative;
Patient Satisfaction;
Retrospective Studies;
Thoracic Surgery
- From:Korean Journal of Anesthesiology
2012;63(6):563-566
- CountryRepublic of Korea
- Language:English
-
Abstract:
We retrospectively report the first use of intrathecal morphine prior to incision in two male patients undergoing a complex aortic reconstruction, who required complete circulatory arrest under deep hypothermia for intraoperative and postoperative pain control. We administered intrathecal morphine to two male patients undergoing circulatory arrest and deep hypothermia. Patients were fully heparinized prior to cardiopulmonary bypass. Deep hypothermic circulatory arrest was performed by cooling the patients to 18degrees C. Following the surgery, the neurologic status was monitored. The management of postoperative pain is a quality standard in health care. During the first 24 hours after surgery, we observed excellent analgesia without the associated side effects, thus, reducing the time required for pain control by the nursing staff. A successful analgetic strategy not only enhances the patient satisfaction, but may improve the postoperative outcome. However, complications, such as increased risk of epidural hematoma formation, are of special concern in cardiac surgery.
