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Mini-dose (0.05 mg) intrathecal morphine provides effective analgesia after transurethral resection of the prostate

[Une mini dose (0,05 mg) de morphine intrathécale fournit une analgésie efficace après la résection transurétrale de la prostate]

Tetsuya Sakai, MD^*, Tadasuke Use, MD, Hiroko Shimamoto, MD, Taku Fukano, MD and Koji Sumikawa, MD^*

^* From the Departments of Anesthesiology, Nagasaki University School of Medicine,
and the Sasebo Kyosai Hospital, Nagasaki, Japan.

Address correspondence to: Dr. Tetsuya Sakai, Department of Anesthesiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. Phone: +81-95-849-7370; Fax: +81-95-849-7373; E-mail: tscat{at}fb3.so-net.ne.jp

Purpose: To determine the optimal dose of intrathecal morphine that produces satisfactory analgesia with minimum side effects in elderly patients undergoing transurethral resection of the prostate (TURP).

Methods: In this double-blind prospective study, 42 patients undergoing TURP with spinal anesthesia were allocated to one of three groups. Group A (n = 14) received tetracaine, 10 mg, alone. Group B (n = 13) and Group C (n = 15) received morphine 0.05 mg and 0.10 mg, respectively, in combination with tetracaine. Postoperative pain, nausea and pruritus were evaluated using visual analogue scales (VAS). SpO₂ and respiratory rate were also assessed.

Results: At three, five, seven and 24 hr after spinal anesthesia, the VAS scores for pain in Groups B and C were significantly less than in Group A. Group C experienced significantly greater VAS scores for pruritus as compared to Groups A and B. There was no significant difference in the intensity of nausea among the three groups. No patient experienced hypoxemia (SpO₂ < 90%) and respiratory depression (respiratory rate < 10 beats•min^-1) in any group.

Conclusion: A dose of 0.05 mg in intrathecal morphine with spinal anesthesia would be optimal for elderly patients undergoing TURP.

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