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

  • Regional Anesthesia (P Kukreja, Section Editor)
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Abstract

Purpose of Review

The 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 Findings

Recent 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.

Summary

Intrathecal 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.

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Data Availability

No datasets were generated or analysed during the current study.

References

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  1. Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham (UAB), UAB Hospital, Birmingham, AL, 35233, USA

    Paul Piennette, John Ahn, Andrew S. Braun & Christopher Paul

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P.P. wrote, reviewed and prepared main manuscript and tables and responded to revisions J.A. wrote, reviewed and prepared main manuscript and tables A.B. wrote, reviewed and prepared main manuscript and tables C.P. wrote and prepared main manuscript contributions.

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Piennette, P., Ahn, J., Braun, A.S. et al. Current Review of the Use of Intrathecal Morphine for Postoperative Analgesia in Total Joint Arthroplasty. Curr Anesthesiol Rep 14, 83–89 (2024). https://doi.org/10.1007/s40140-023-00598-6

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