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J R Soc Med. 1995 February; 88(2): 70–72.
PMCID: PMC1295098

Postoperative analgesia following total hip replacement: a comparison of intrathecal morphine and diamorphine.


Sixty patients undergoing elective total hip replacement under spinal anaesthesia were randomly assigned to receive either intrathecal (IT) diamorphine 0.75 mg (n = 30) or IT morphine 1.0 mg (n = 30). Postoperative pain scores, analgesic requirements and side effects were assessed by a blinded observer. Postoperative pain scores were broadly similar and satisfactory for both groups but the amount of additional IV morphine required to achieve this was significantly reduced in the morphine compared with the diamorphine group (P < 0.05). Twelve of the morphine group required no postoperative analgesics compared with four in the diamorphine group (P < 0.02). There were no differences between the groups in the incidence of side effects such as emesis and pruritus. No significant postoperative respiratory depression was noted. In the doses used intrathecal morphine provided superior postoperative analgesia to that of intrathecal diamorphine.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Barron DW, Strong JE. The safety and efficacy of intrathecal diamorphine. Pain. 1984 Mar;18(3):279–285. [PubMed]
  • Wang JK, Nauss LA, Thomas JE. Pain relief by intrathecally applied morphine in man. Anesthesiology. 1979 Feb;50(2):149–151. [PubMed]
  • Barron DW, Strong JE. Postoperative analgesia in major orthopaedic surgery. Epidural and intrathecal opiates. Anaesthesia. 1981 Oct;36(10):937–941. [PubMed]
  • Jacobson L, Kokri MS, Pridie AK. Intrathecal diamorphine: a dose-response study. Ann R Coll Surg Engl. 1989 Sep;71(5):289–292. [PMC free article] [PubMed]
  • McQuay HJ, Sullivan AF, Smallman K, Dickenson AH. Intrathecal opioids, potency and lipophilicity. Pain. 1989 Jan;36(1):111–115. [PubMed]

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