Spinal (Subarachnoid) Morphine for Off-Pump Coronary Artery Bypass Surgery
DOI:
https://doi.org/10.1532/HSF98.20033014Abstract
Objective: To study the effects of 8 mg/kg preoperatively administered intrathecal morphine sulfate on extubation time, postoperative pulmonary function, and postoperative analgesia after off-pump coronary artery bypass grafting (OPCAB).
Design: A prospective, randomized, double-blind, placebo-controlled study.
Participants: One hundred adult patients scheduled for elective primary OPCAB.
Interventions: Patients were randomized to preoperative administration of 8 m g/kg intrathecal morphine sulfate (group 1) with a 25-gauge spinal needle or to receive sterile normal saline placebo subcutaneously (group 2). Anesthetic induction and maintenance were standardized to allow planning for facilitating early tracheal extubation. Multivessel OPCAB was performed with an Octopus stabilizer. Patients were extubated in the intensive care unit by a blinded observer using predefined extubation criteria.
Measurements and Main Results: Postoperative times to extubation were 9.47 ± 3.83 hours in group 1 versus 11.25 ± 3.94 hours in group 2 (P = .025). Postextubation bedside spirometric lung volumes in percentage of preoperative lung volume showed significant differences in group 1 versus group 2 in forced vital capacity, 39.66% ± 15.42% versus 31.85% ± 11.65% (P = .016); forced expiratory volume in the first second, 44.8% ± 16.18% versus 35.97% ± 13.32% (P = .013); maximum voluntary ventilation, 39.40% ± 13.57% ver-
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