Department of Surgical Sciences

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Browsing Department of Surgical Sciences by Subject "Intrathecal fentanyl"

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    A comparison of intrathecal morphine or fentanyl on the duration of postoperative analgesia at Namibian teaching hospitals in Windhoek
    (University of Namibia, 2022) Murakwani, Mandiudza Maria
    Background: Pain management is a cornerstone in the management of femoral fractures. Poorly controlled perioperative pain is associated with detrimental short-term and long-term effects. Addition of intrathecal opioids has been shown to produce a dense block and enhance analgesic effect. The objective of the study was to compare the duration of postoperative analgesia of intrathecal morphine or fentanyl for femur fracture surgery at Namibian Teaching Hospitals in Windhoek. Methodology: This was a prospective randomised double blinded control study which was done in February – July 2021; in which 60 patients above 18 years scheduled for femur fracture surgeries received standard spinal anaesthesia with 0.5% heavy bupivacaine 12.5 mg plus 100 mcg morphine (ITM group) or 25 mcg fentanyl (ITF group). Data was collected using a form designed for the study and analysed with the statistical package for social sciences (SPSS for windows 26.0, SPSS Inc., Chicago, IL, USA). Results: Participants in the ITM group had a significantly longer time to first request for analgesic (14.5 ±8.03 hours) versus the ITF group (7.07 ± 3.07 hours), p =0.0001 and reduced total opioid consumption in 24 hours. The postoperative pain scores (verbal numerical rating scale) at rest and with movement were significantly lower in 2nd, 4th and 6th hour in the ITM group compared to the ITF group (p <0.05). No significant difference was observed between the two groups in terms of pruritus, nausea and vomiting. Respiratory depression was not observed in any participant in the two groups. Patient satisfaction with analgesia was superior in the ITM group (p =0.0001). No significant association was confirmed between type of femur fracture and the total opioid consumption in 24 hours. Conclusion: Use of intrathecal morphine significantly increased the duration of postoperative analgesia and reduced the total opioid consumption.