Analgesic Efficacy of Subarachnoid Morphine versus Intravenous in Postoperative Patients with Total Abdominal Hysterectomy in Mexico

Background: Pain relief in total abdominal hysterectomy by any effective method and especially with regional anesthesia, avoids or attenuates many of the effects of pain. The literature supports the use of opioids through a subarachnoid catheter to achieve adequate postoperative analgesia compared to intravenous or intramuscular use; demonstrating adequate levels of postoperative analgesia and better pain management for up to 24 hours. Aim: So the purpose of this study is to compare the analgesic efficacy of subarachnoid morphine versus intravenous use in postoperative patients of total abdominal hysterectomy in Ciudad Obregon, Sonora. Design and Setting: Quasi-experimental randomized, prospective and longitudinal clinical trial. Methods: The study was conducted in Ciudad Obregon, Sonora, from 01 to 30 May 2016, in patients with total abdominal hysterectomy; a total of 62 patients were divided into two groups, 31 for each group, group A received subarachnoid morphine, group B intravenous morphine. The pain measurement was performed through the analogous visual scale on four times: baseline, end of surgery, 30 minutes, 6 hours, 12 hours and 24 hours. Results: The results indicate that the best route of application is the subarachnoid because the pain was reported with less intensity and in smaller occasions in patients belonging to group A. Conclusion: Both routes of application meet the goal of reducing patient pain; however, subarachnoid route is more advisable than the intravenous for its efficiency.