Postoperative hemodynamics after high spinal block with or without intrathecal morphine in cardiac surgical patients: a randomized-controlled trial

There is some evidence for the use of intrathecal morphine as a means to provide prolonged analgesia in selective cardiac surgical patients; however, hemodynamic effects are not well defined. This study was designed effect on parameters surgery patients. In prospective, double-blind study, 100 adult patients were randomized receive either 40 mg 0.5% hyperbaric bupivacaine alone (intrathecal [ITB] group, n = 50) or 250 µg added and [ITBM] 50). Hemodynamic data, pain scores, rescue analgesic use, spirometry, vasopressor recorded every four hours after 48 hr. The primary outcome incidence vasoplegia each which defined index > 2.2 L·min-1·m-2 with requirement vasopressors maintain mean arterial pressure 60 mmHg episode lasting hours. Eighty-seven analyzed (ITB 42, ITBM =45). higher group than ITB [14 (31%) vs 5 (12%), respectively; relative risk, 2.6; 95% confidence interval [CI], 1.0 6.6; P 0.04]. (standard deviation [SD]) duration significantly longer [8.9 (3.0) hr 4.3 (0.4) hr, difference means, 4.6; CI, 3.7 5.5; < 0.001]. Intrathecal high spinal anesthesia increases www.clinicaltrials.gov (NCT02825056); registered 19 June 2016.