Anest. intenziv. Med. 2024;35(3):155-161 | DOI: 10.36290/aim.2024.030

Spinal morphine up­‑to­‑dateReview Article

Buršík D.^{1, 2}, Romanová T.^{1, 5}, Vodička V.^{1, 2}, Jor O.^{1, 3}, Máca J.^{1, 3, 4}

¹ Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Ostrava

² Lékařská fakulta, Masarykova univerzita, Brno

³ Klinika anesteziologie, resuscitace a intenzivní medicíny, Lékařská fakulta, Ostravská univerzita, Ostrava

⁴ Ústav fyziologie a patofyziologie, Lékařská fakulta, Ostravská univerzita, Ostrava

⁵ Katedra chirurgických oborů, Lékařská fakulta, Ostravská univerzita, Ostrava

Over many decades, spinal (intrathecal) opioid administration has become a proven method of analgesia for the perioperative period. However, in clinical practice, it is confronted with concerns about potential complications, the need for increased postoperative monitoring, and the unavailability of a relevant commercial product on the Czech market. Pathophysiological interpretation of adverse effects and their potential prevention is evolving as research continues. The implementation of spinal opioids in clinical practice is likewise changing. When used appropriately, it is a safe method to improve the postoperative course of the full spectrum of surgical procedures across age groups. Thus, healthcare facilities with individually prepared morphine for intrathecal administration can enjoy the benefits of not only quality patient analgesia but also the minimization of peripheral adverse effects of opioids. This article aims to highlight new findings on the use of spinal morphine. It also focuses on the preventability of its adverse effects and the specifics of its use in the elderly population.

Keywords: opioids, intrathecal morphine, multimodal analgesia, anaesthesia in the elderly.

Received: May 17, 2024; Revised: June 18, 2024; Accepted: July 16, 2024; Prepublished online: August 12, 2024; Published: October 7, 2024  Show citation