- Morphine Spinal Block Anesthesia in Patients Who Undergo an Open Hemorrhoidectomy: A Prospective Analysis of Pain Control and Postoperative Complications
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Hélio Moreira, José PT Moreira, Raniere R Isaac, Onofre Alves-Neto, Thiago AC Moreira, Tiago HM Vieira, Andressa MS Brasil
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Ann Coloproctol. 2014;30(3):135-140. Published online June 23, 2014
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DOI: https://doi.org/10.3393/ac.2014.30.3.135
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- Purpose
This study evaluated the use of adding morphine to bupivacaine in spinal anesthesia for pain control in patients who underwent an open hemorrhoidectomy. MethodsForty patients were prospectively selected for an open hemorrhoidectomy at the same institution and were randomized into two groups of 20 patients each: group 1 had a spinal with 7 mg of heavy bupivacaine associated with 80 µg of morphine (0.2 mg/mL). Group 2 had a spinal with 7 mg of heavy bupivacaine associated with distilled water, achieving the same volume of spinal infusion as that of group 1. Both groups were prescribed the same pain control medicine during the postoperative period. Pain scores were evaluated at the anesthetic recovery room and at 3, 6, 12, and 24 hours after surgery. Postoperative complications, including pruritus, nausea, headaches, and urinary retention, were also recorded. ResultsThere were no anthropometric statistical differences between the two groups. Pain in the anesthetic recovery room and 3 hours after surgery was similar for both groups. However, pain was better controlled in group 1 at 6 and 12 hours after surgery. Although pain was better controlled for group 1 after 24 hours of surgery, the difference between the groups didn't achieved statistical significance. Complications were more common in group 1. Six patients (6/20) presented coetaneous pruritus and 3 with (3/20) urinary retention. ConclusionA hemorrhoidectomy under a spinal with morphine provides better pain control between 6 and 12 hours after surgery. However, postoperative complications, including cutaneous pruritus (30%) and urinary retention (15%), should be considered as a negative side of this procedure.
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Citations
Citations to this article as recorded by  - Pulmonary complications after intrathecal morphine administration: a systematic review and meta‐analysis with meta‐regression and trial sequential analysis
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Anaesthesia.2025;[Epub] CrossRef - Intradermal methylene blue analgesic application in posthemorrhoidectomy pain management: a randomized controlled trial
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Frontiers in Surgery.2024;[Epub] CrossRef - The effect of bupivacaine on analgesia and safety in patients undergoing hemorrhoidectomy: a meta-analysis
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Frontiers in Pharmacology.2024;[Epub] CrossRef - Non-pulmonary complications of intrathecal morphine administration: a systematic review and meta-analysis with meta-regression
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British Journal of Anaesthesia.2024; 133(4): 823. CrossRef - Ten-year multicentric retrospective analysis regarding postoperative complications and impact of comorbidities in hemorrhoidal surgery with literature review
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Anatolian Current Medical Journal.2021; 3(2): 124. CrossRef - Endogenous Opiates and Behavior: 2015
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Peptides.2017; 88: 126. CrossRef - Evidence‐Based Management of Pain After Excisional Haemorrhoidectomy Surgery: A PROSPECT Review Update
Tarik Sammour, Ahmed W. H. Barazanchi, Andrew G. Hill, Francis Bonnet, Barrie Fischer, Girish Joshi, Henrik Kehlet, Philipp Lirk, Narinder Rawal, Stephan Schug, Marc Van de Velde, Marcel Vercauteren
World Journal of Surgery.2017; 41(2): 603. CrossRef - Prolonged Opioid-Sparing Pain Control after Hemorrhoidectomy with Liposome Bupivacaine: Results from a Cohort of 95 Patients
Allen B. Jetmore, Douglas Hagen
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Byung Chun Kim
Annals of Coloproctology.2014; 30(3): 107. CrossRef
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