{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:57:11Z","timestamp":1777463831853,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T00:00:00Z","timestamp":1657843200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["British Journal of Pain"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:p>Single-shot spinal diamorphine is becoming common practice in urological surgery to aid post-operative pain; however, its safety and efficacy require investigation. This study is a retrospective analysis of 113 laparoscopic or robotic-assisted nephrectomies over 4\u00a0years under one consultant urologist. Data were collected on demographic, pre-operative scores, anaesthesia, surgical information, post-operative outcomes and opioid consumption. Two main groups were established: no spinal diamorphine (NSD) and spinal diamorphine (SD). Four subgroups were then created, separating those who received patient-controlled anaesthesia (PCA) or not: Group 1 [general anaesthetic (GA)]; Group 2 [GA and PCA]; Group 3 [GA and spinal diamorphine] and Group 4 [GA, spinal diamorphine and PCA]. Ninety-eight eligible patients were identified. At 6\u00a0hours, pain scores were significantly higher for all non-spinal groups ( p &lt; 0.05); at 9\u00a0h, pain scores were significantly higher in NSD patients compared to SD ( p = 0.026); at 12\u00a0h, pain scores were significantly higher for NSD patients compared to SD ( p = 0.024), and Group 1 compared to Group 3 ( p = 0.023). Total opioid consumption in the first 24\u00a0h post-surgery was higher in Group 1 compared to Group 3 ( p = 0.024). There was no higher incidence of urinary retention, or any neurological complications reported within the SD patients. The study found a reduction in post-operative pain scores with the use of spinal diamorphine prior to laparoscopic and robotic-assisted nephrectomies. The findings may also suggest that pre-operative spinal diamorphine use can reduce the total volume of opioids administered via other routes in the first 24\u00a0h post-operatively. It recommends its routine administration but encourages prospective investigation.<\/jats:p>","DOI":"10.1177\/20494637221115926","type":"journal-article","created":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T22:10:27Z","timestamp":1657923027000},"page":"632-640","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Single-shot spinal diamorphine for laparoscopic nephrectomy: A retrospective study"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3766-5594","authenticated-orcid":false,"given":"R","family":"Vicary-Watts","sequence":"first","affiliation":[{"name":"Department of Urology, Lancashire Teaching Hospitals, Preston, Lancashire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Urology, Lancashire Teaching Hospitals, Preston, Lancashire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O","family":"Passmore-Szilagyi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Lancashire Teaching Hospitals, Preston, Lancashire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Zelhof","sequence":"additional","affiliation":[{"name":"Department of Urology, Manchester University NHS Foundation Trust, Manchester, GM, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,7,15]]},"reference":[{"key":"bibr1-20494637221115926","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-017-2040-6"},{"key":"bibr2-20494637221115926","doi-asserted-by":"publisher","DOI":"10.3109\/10929088.2010.541620"},{"key":"bibr3-20494637221115926","first-page":"4736","volume":"16","author":"Guru K","year":"2009","journal-title":"Can J 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