Objective: Postoperative pain (POP) following abdominal surgery can vary from a few hours to several days. This acute, unrelieved pain can become chronic, requiring patients to take analgesics on an almost daily basis for comfort. Analgesia using general opioids has many side effects and intrathecal morphine is a good alternative. This study was conducted to evaluate the efficacy of intrathecal morphine (ITM) versus conventional analgesia in the management of postoperative pain in colectomy performed by laparoscopic surgery. Methods: Cohort study conducted at the H？pital Nord in Marseille, from 01 January to 31 July 2021 in patients aged at least 18 years undergoing anaesthesia for scheduled colectomy by laparoscopic surgery. The primary endpoint was postoperative pain intensity and the secondary endpoints were morphine consumption, treatment side effects and length of hospital stay. Statistical analysis was performed using XLSTAT software. Results: We included 193 patients: 131 in the control group (conventional analgesia) and 62 in the ITM group. We observed: a significant decrease in pain (assessed by numerical scale) in favour of the ITM group in the post-anaesthetic care room, i.e. 3 (±4) vs 1 (±2), p < 0.0001 at H0 and H2: 2 (±2) vs. 1 (±2); p < 0.0001; and in the first 24 postoperative hours 5 (±3) vs. 2 (±3); p < 0.0001, a significant decrease in total morphine consumption at day zero in the ITM vs. control group (23 mg (±15) % vs. 2 mg (±5); p < 0.001), significantly greater morphine side effects in the control group (51% vs. 15%, p < 0.0001), a non-significant reduction in hospital length of stay in favour of the ITM group (8d (±6) vs. 6d (±4) days, p = 0.054). Conclusion: These results suggest that intrathecal morphine (ITM) in laparoscopic colectomy provides effective postoperative analgesia with low morphine consumption, and a reduction in morphine side-effects compared with conventional analgesia.
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