The Effectiveness of Spinal Morphine Plus Intravenous Patient-Controlled Analgesia on Postoperative Pain Controlled at Srinagarind Hospital

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Malinee Wongswadiwat
Janjira Kuanratikul
Somboon Thienthong
Sasiwimol Ponjanyakul
Panaratana Ratanasuwan Yimyaem
Wimonrat Sriraj



Background and Objective: Effective pain control can minimize post operative complications especially for pulmonary complications. Previous reports showed pain management using combined spinal morphine (spinal MO) plus patient-controlled analgesia (IV PCA) was more effective than either intravenous or PCA alone. This technique had been conducted in our institute since 2004 but its effect on postoperative pain control was not reported. Aim to study the effect of spinal morphine plus  IV PCA on postoperative pain control

Methods: The author conducted this descriptive study at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, by retrospectively reviewing all medical record of surgical patients who received spinal morphine plus PCA for postoperative analgesia between January 2005 and December 2006. Data extracted were age, gender, types of operation, dosage of spinal morphine, pain scores (both at rest and during movement) on the first post operative day, adverse effects, and patient’s satisfaction.Effect of the pain control were classified as; effective (pain score 0-4) and ineffective (pain score 5-10)

Results: Two hundred and sixty two records were analyzed. There were 63% female with a mean age of 49.6±10.5 years. Most of patients (69%) underwent abdominal surgery (excluded cesarean section and kidney surgery). Median dosage of spinal morphine was 0.3 mg depending on types of surgery. There were 62% of cases received effective analgesia at rest whereas 35.4% received while movement. No respiratory depression was reported but 1.5% of patients experienced severe nausea and vomiting. However, 92% of patients were satisfied with the treatment received.

Conclusion: Spinal morphine plus PCA is effective for pain control in the first postoperative day only for at rest, but not during movement.

Keywords: postoperative pain, spinal morphine, patient-controlled analgesia


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