%0 Journal Article
%T The use of high
%A Anil Karmali
%A Jackline Nkhoma
%A John Jeans
%A Jonathan Cousins
%A Michael Kynoch
%A Thomas G Wojcikiewicz
%J British Journal of Pain
%@ 2049-4645
%D 2019
%R 10.1177/2049463718800521
%X The use of intrathecal diamorphine is not commonplace in laparoscopic bariatric surgery. At our institution, a major UK bariatric centre, high-dose intrathecal diamorphine is routinely utilised. Data were analysed retrospectively. Fifty-three patients who had a spinal anaesthetic were matched against age, sex, body mass index and surgical procedure type to generate controls. Pain scores were recorded in the post-anaesthetic care unit on arrival, after 1£¿hour and on discharge to the ward. Post-operative nausea and vomiting; post-operative hypertension; pruritus; 24-hour morphine consumption and length of stay were measured. Pain scores were better in the spinal anaesthetic group in all measured categories (p£¿=£¿0.033, p£¿<£¿0.01, p£¿<£¿0.01); post-operative nausea and vomiting was less common in the spinal anaesthetic group (p£¿<£¿0.01); post-operative hypertension was less common in the spinal anaesthetic group (p£¿=£¿0.25); pruritus was more common in the spinal anaesthetic group (p£¿<£¿0.01); morphine consumption was less common in the spinal anaesthetic group (p£¿=£¿0.037). Length of hospital stay was reduced by 12.4£¿hours (p£¿=£¿0.025). We propose that this is a practical and safe technique to adopt. A randomised-control trial will need to be conducted in order to find the most efficacious volume of local anaesthetic and dose of diamorphin
%K Intrathecal
%K diamorphine
%K neuroaxial
%K bariatric
%K bariatric surgery
%U https://journals.sagepub.com/doi/full/10.1177/2049463718800521