July 10, 2019

Student-led analysis shows morphine injection in spine may reduce opiate needs post-surgery

Wayne State University School of Medicine student Arif Musa has demonstrated that the addition of intrathecal morphine at low dosages to reduce postoperative pain after pediatric spine surgery provides an immediate analgesic effect, theoretically reducing the need for opiates after surgery.

Arif Musa
Arif Musa is a Class of 2022 medical student.

Intrathecal morphine involves the injection of morphine into the subarachnoid space, delivering a small dose directly to the spinal opioid receptors.

“A great deal of importance has been placed upon reducing reliance on opiates after surgery due to the potential for opioid-related side effects and potential addiction,” said Musa, a member of the Class of 2022. “We found that the time to first analgesic demand was greater among patients given intrathecal morphine. The patients also consumed less analgesic at 24 hours and 48 hours after surgery. Notably, administration of intrathecal morphine did not significantly increase rates of respiratory depression, nausea, vomiting and pruritus (skin itch).”

Musa performed the research the summer before beginning medical school last fall. He quickly saw how WSU’s curriculum was developing his clinical knowledge earlier.

“As part of the Musculoskeletal Unit, I was responsible for understanding the anatomy of the spinal cord and dura mater. In gross anatomy dissection, I was able to identify each layer of the meninges – dura mater, arachnoid mater and pia mater,” he said. “I was therefore able to see exactly where intrathecal morphine is injected – in the subarachnoid space between the arachnoid mater and pia mater. This is just one example of how Wayne State University School of Medicine’s emphasis on gross anatomy dissection helped me develop my clinical knowledge and led to direct application of my knowledge.”

A publication resulting from Musa’s work as part of a research team at the University of California at Irvine’s Department of Orthopaedic Surgery, “Addition of Intrathecal Morphine for Postoperative Pain Management in Pediatric Spine Surgery: A Meta-Analysis,” was included in the April issue of the journal Clinical Spine Surgery.

The meta-analysis included five studies – three randomized controlled trials and two retrospective chart reviews of 636 subjects.