Current Review of the Use of Intrathecal Morphine for Postoperative Analgesia in Total Joint Arthroplasty

AbstractPurpose of ReviewThe use of neuraxial opioids (NAO) as a method for postoperative analgesia for patients undergoing total joint arthroplasty (TJA) is growing in popularity. Intrathecal morphine (ITM) remains the most commonly used NAO. The purpose of this article is to provide readers with an overview of ITM, as well as a comprehensive review of efficacy, dosing, side effects, complications, and adjuncts of ITM when used for TJA.Recent FindingsRecent randomized control trials and meta-analyses provide comprehensive evidence on the usefulness of ITM for TJA. Many of these publications demonstrate clear favorability regarding pain outcomes for TJA patients who receive ITM in the perioperative setting. Additional publications help explain the risk for adverse events and complications associated with routine use of ITM.SummaryIntrathecal morphine is a safe and efficacious modality for providing postoperative analgesia in TJA. A universal approach to optimizing postoperative pain that includes routine use of ITM has yet to be established. Continued research is needed to more clearly define the role that ITM plays in a multi-approach pathway to postoperative analgesia in TJA.
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research