{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:28:34Z","timestamp":1792024114845,"version":"4.4.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,11,8]],"date-time":"2020-11-08T00:00:00Z","timestamp":1604793600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Colorectal cancer surgery is commonly performed with adequate analgesia essential for patient recovery. This study assessed the effectiveness of intrathecal morphine and patient-controlled analgesia (ITM + PCA) vs patient-controlled analgesia alone (PCA) for postoperative pain management in colorectal cancer surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study extracted and analyzed data covering a 4-year period (2014\u20132018) from a clinical database with 24- and 48-hour postsurgery follow-up. Primary outcomes included pain scores, median opioid consumption (oral morphine equivalence dose), sedation, nausea and vomiting, and length of admission. Outcomes were analyzed for ITM + PCA vs PCA alone, overall and stratified by laparotomy or laparoscopy procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 283 patients were included: ITM + PCA (163) and PCA alone (120). Median opioid consumption in the first 24\u00a0hours for ITM + PCA vs PCA alone was lower for laparotomy (\u201332.7\u00a0mg, P&amp;lt;0.001) and laparoscopy (\u201314.3\u00a0mg, P&amp;lt;0.001). Median pain score (worst pain) within the first 24\u00a0hours for ITM + PCA vs PCA alone was similar for laparotomy (P&amp;gt;0.05) and lower for laparoscopy (\u20131 unit, P=0.031). Sedation occurred less frequently for ITM + PCA vs PCA at 24\u00a0hours (3.5% vs 11.4%, P=0.031), with nonsignificant reduction at 48\u00a0hours (4.8% vs 18.8%, P=0.090) for laparotomy, but with no difference for laparoscopy (P&amp;gt;0.05). Incidence of nausea and vomiting and length of admission were similar for ITM + PCA vs PCA alone for laparotomy or laparoscopy (P&amp;gt;0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This retrospective study demonstrated that ITM + PCA can achieve similar analgesic effects after laparotomy and laparoscopy colorectal cancer surgery compared with PCA alone while resulting in a reduction of oral opioid consumption and lower incidence of sedation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/pm\/pnaa319","type":"journal-article","created":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T08:44:29Z","timestamp":1597740269000},"page":"402-406","source":"Crossref","is-referenced-by-count":9,"title":["Intrathecal Morphine in Postoperative Analgesia for Colorectal Cancer Surgery: A Retrospective Study"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7142-8288","authenticated-orcid":false,"given":"Jamie","family":"Young","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Pain, Peter MacCallum Cancer Centre, Melbourne, Australia"},{"name":"Centre for Integrated Critical Care, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alistair","family":"Macpherson","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arti","family":"Thakerar","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marliese","family":"Alexander","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, Australia"},{"name":"Department of Oncology, University of Melbourne, Parkville, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,8]]},"reference":[{"issue":"9719","key":"2021022320184430100_pnaa319-B1","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/S0140-6736(10)60353-4","article-title":"Colorectal cancer","volume":"375","author":"Cunningham","year":"2010","journal-title":"Lancet"},{"issue":"6","key":"2021022320184430100_pnaa319-B2","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1111\/j.1365-2044.2008.05817.x","article-title":"Risks and side-effects of intrathecal morphine combined with spinal anaesthesia: A meta-analysis","volume":"64","author":"Gehling","year":"2009","journal-title":"Anaesthesia"},{"issue":"3","key":"2021022320184430100_pnaa319-B3","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1093\/bjaceaccp\/mkn016","article-title":"Intrathecal opioids in the management of acute postoperative pain","volume":"8","author":"Hindle","year":"2008","journal-title":"Continuing Educ Anaesth Crit Care Pain"},{"issue":"3","key":"2021022320184430100_pnaa319-B4","first-page":"255","article-title":"High dose intrathecal morphine for major abdominal cancer surgery: A prospective double-blind, dose-finding clinical study","volume":"17","author":"Fares","year":"2014","journal-title":"Pain Physician"},{"issue":"6","key":"2021022320184430100_pnaa319-B5","first-page":"531","article-title":"Postoperative analgesia and recovery course after major colorectal surgery in elderly patients: A randomized comparison between intrathecal morphine and intravenous PCA morphine","volume":"31","author":"Beaussier","year":"2006","journal-title":"Reg Anesth Pain Med"},{"issue":"2","key":"2021022320184430100_pnaa319-B6","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1093\/bja\/aen368","article-title":"Benefit and risk of intrathecal morphine without local anaesthetic in patients undergoing major surgery: Meta-analysis of randomized trials","volume":"102","author":"Meylan","year":"2009","journal-title":"Br J Anaesth"},{"issue":"4","key":"2021022320184430100_pnaa319-B7","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/BF03021032","article-title":"Intrathecal + PCA morphine improves analgesia during the first 24 hr after major abdominal surgery compared to PCA alone","volume":"50","author":"Devys","year":"2003","journal-title":"Can J Anesth"},{"key":"2021022320184430100_pnaa319-B8","year":"2018"},{"key":"2021022320184430100_pnaa319-B9","author":"IBM","year":"2015","journal-title":"IBM SPSS Statistics for Windows, Version 23.0. 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