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Survey of intrathecal opioid usage in the UK

Published online by Cambridge University Press:  01 February 2008

M. Giovannelli ,
N. Bedforth  and
A. Aitkenhead
M. Giovannelli*
Affiliation:
Derby Hospitals NHS Foundation Trust, Department of Critical Care, Derby, UK
N. Bedforth
Affiliation:
Queen’s Medical Centre, Department of Anaesthesia, Nottingham, UK
A. Aitkenhead
Affiliation:
Queen’s Medical Centre, Department of Anaesthesia, Nottingham, UK
*
Correspondence to: Marco A. Giovannelli, Department of Critical Care, Derby Hospitals NHS Foundation Trust, Uttoxeter Road, Derby DE22 3NE, UK. E-mail: marco.giovannelli@derbyhospitals.nhs.uk; Tel: 01332 347141; Fax: 01332 258118
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Summary

Background and objective

Intrathecal opioids are now used routinely in the UK for intra- and postoperative analgesia. The opioids of choice have altered over recent years and the dosage regimens used can vary between institutions. Concerns over safety have been reduced probably because much lower doses of opioids are now being used. This survey explored the practice of intrathecal opioid usage in the UK.

Methods

We sent a questionnaire survey to 270 anaesthetic departments and received 199 replies, a response rate of 73.7%.

Results

Intrathecal opioids were used in 175 (88.4%) departments. Of these departments, 107 (61.1%) had local guidelines or protocols in place. Opioids such as diamorphine (used in 136 (78.2%) of departments) and fentanyl (129 (74.1%)) with a shorter duration of action are now more commonly used than morphine (37 (21.3%)) for intrathecal analgesia. In 96 (54.5%) departments, patients were nursed on regular surgical wards following administration of spinal opioids.

Conclusions

The use of low-dose lipophilic intrathecal opioids for postoperative analgesia is widespread in the UK. Patients are commonly nursed in low-dependency post-anaesthetic care areas. The low incidence of adverse events reported by the respondents along with the popularity of the technique suggests that low-dose spinal opioid administration is safe.

Keywords

ANAESTHESIASPINALANALGESICS OPIOID, morphine, fentanyl, diamorphineANAESTHESIA RECOVERY PERIODGUIDELINES
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 2 , February 2008 , pp. 118 - 122
Copyright
Copyright © European Society of Anaesthesiology 2007

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