Intrathecal Morphine for Postoperative Analgesia: Balance of Efficacy and Safety

Abstract

Intrathecal morphine (ITM) has been a reliable technique for postoperative pain management since 1979. As a key component of multimodal analgesia, ITM provides long-lasting pain relief. ITM’s simplicity, lack of need for expensive equipment, and minimal training requirements contribute to its wide use. In this article, we highlight the current state of affairs in terms of ITM for postoperative analgesia, including aspects that are still under debate. In particular, we emphasize the doses that are efficacious while minimizing the risk of respiratory depression. Further, we believe that when used in low doses (<200 mcg) and without the administration of potential augmenting medications, intrathecal morphine does not pose a greater risk of respiratory depression than systemic opioid therapies commonly used in routine clinical practice. We particularly emphasize that standard nursing care is sufficient for postanesthesia monitoring of patients in such cases.