Analgésie et réanimation : recherche actuelle

Prospective Study of Intrathecal Morphine versus Patient Controlled Analgesia in Cardiac Patients

Haris Bilal, Nnanyelu Nzeakor, Karim Morcos and Dumbor L Ngaage

Prospective Study of Intrathecal Morphine versus Patient Controlled Analgesia in Cardiac Patients

Median sternotomy, the most common access used for cardiac surgery, is usually associated with severe early postoperative pain. Aggressive sternotomy pain control facilitates recovery, early mobilisation and decreases post-operative morbidity with  direct implications for clinical resource utilisation and cost. Strategies to achieve effective early postoperative pain control after cardiac surgery have been reported to include; the use of opioids delivered as intravenous infusion, intravenous patient-controlled analgesia, epidural infusion, epidural patient-controlled analgesia, single intrathecal bolus, and intermittent subcutaneous boluses. Local anaesthetic agents have been injected into the surgical site, or thoracic epidural space as boluses and/or infusion.