Comparison of the efficacy of spinal morphine administered at different doses topatients undergoing lung resection

Objective: Thoracic surgery is one of the surgeries where postoperative pain is intense. In our study, we aimed to compare the efficacy of two different intrathecal morphine doses administered for postoperative analgesia according to ideal body weight. Material and Method: In our randomized and prospective study, patients who underwent video-assisted thoracic surgery (VATS) were divided into two groups and 10 mcg/kg intrathecal morphine (Group 1) was administered to one group according to ideal body weight and 7 mcg/kg intrathecal morphine (Group 2) according to ideal body weight was applied to the other group for postoperative analgesia. Intraoperative and postoperative hemodynamic variables, postoperative morphine consumption, postoperative VAS (exertion) and VAS (rest) scores, frequency of side effects, and additional analgesic needs were recorded. Results: A total of 46 patients were included in the study. 63% of the patients were male and 37% were female. It was found that the demographic, anthropometric and operative data of the patients did not differ between the groups (p > 0.05). In the intraoperative and postoperative period; There was no significant difference between the two groups in systolic and diastolic arterial pressure and cup velocity follow-up (p > 0.05). It was determined that the FiO2 and SpO2 values of the patients did not differ in the postoperative period in terms of respiratory functions (p > 0.05). While VAS (rest) and VAS (exertion) scores did not differ between the two groups in the first 12 hours, they were lower in Group 1 at 18 and 24 hours (VAS was p=0.024 and p=0.017 for rest, respectively, and p=0.025 and p=0.002 for VAS exertion, respectively). Postoperative morphine consumption was statistically significantly lower in Group 1 at all time periods (p < 0.05). The incidence of side effects was similar for both groups (p > 0.05). Conclusion: As a result of our study, we believe that the application of 10 mcg/kg intrathecal morphine according to the ideal weight for postoperative analgesia in patients who will undergo VATS surgery will provide more effective analgesia without increasing the frequency of side effects compared to 7 mcg/kg intrathecal morphine administration. However, we think that multicenter, prospective studies using wide dose ranges should be carried out in this regard. Key Words: İntratekal morphine, Postoperative analgesia, VAS, VATS, Side effect