Intrathecal morphine and sleep apnoea severity in patients undergoing hip arthroplasty: a randomised, controlled, triple-blinded trial

Details

Serval ID
serval:BIB_5AEB45D045F8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Intrathecal morphine and sleep apnoea severity in patients undergoing hip arthroplasty: a randomised, controlled, triple-blinded trial
Journal
British Journal of Anaesthesia
Author(s)
Albrecht Eric, Bayon Virginie, Hirotsu Camila, Al Ja'bari Aboud, Heinzer Raphaël
ISSN
0007-0912
ISSN-L
0007-0912
Publication state
Published
Issued date
11/2020
Peer-reviewed
Oui
Volume
125
Number
5
Pages
811-817
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Intrathecal morphine prolongs analgesia after surgery, but has been implicated in postoperative respiratory depression or apnoeic episodes. However, this has not been investigated in a prospective trial using respiratory polygraphy. This randomised controlled triple-blinded trial tested the hypothesis that intrathecal morphine increases sleep apnoea severity, measured using respiratory polygraphy.
Sixty subjects undergoing hip arthroplasty under spinal anaesthesia received either 15 mg isobaric bupivacaine 0.5% with 0.5 ml normal saline 0.9% (control group) or 15 mg isobaric bupivacaine 0.5% with 0.5 ml intrathecal morphine 100 μg (intrathecal morphine group). Respiratory polygraphy was performed before surgery and on the first and third postoperative nights. The primary outcome was the apnoea-hypopnoea index in the supine position (supine AHI) on the first postoperative night. Secondary outcomes included supine AHI on the third postoperative night, oxygen desaturation index (ODI), and ventilatory frequency during the first and third postoperative nights.
On the first postoperative night, mean (95% confidence interval) values for supine AHI were 20.6 (13.9-27.3) and 21.2 (12.4-30.0) events h <sup>-1</sup> in the control and intrathecal morphine groups, respectively (P=0.90). There were no significant between-group differences for any of the secondary outcomes, except for a significantly higher central and mixed apnoea index preoperatively and significantly lower mean SpO <sub>2</sub> on the third postoperative night in the control group.
Intrathecal morphine did not increase sleep apnoea severity when measured using respiratory polygraphy. Of note, all patients had an increased number of apnoeic episodes on the third postoperative night.
NCT02566226.
Keywords
Anesthesiology and Pain Medicine
Pubmed
Web of science
Open Access
Yes
Funding(s)
Swiss National Science Foundation / Projects / 32003B_169974
Create date
14/09/2020 8:50
Last modification date
26/01/2021 7:24
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