A Comparison of Intrathecal Opioid and Intravenous Analgesia for the Incidence of Cardiovascular, Respiratory, and Renal Complications after Abdominal Aortic Surgery

A multifaceted stress response occurs as a result of surgery that can produce a variety of symptoms that increase morbidity and adverse cardiac events. The authors studied whether providing intense analgesia in order to eliminate or decrease a source of stress following the surgical procedure would decrease major nonsurgical complications. Patients were randomized to receive either general anesthesia combined with intrathecal opioid or general anesthesia alone (control). Both groups received patient-controlled anesthesia postoperatively and identical postoperative care. A visual analog scale rating postoperative pain was given to each patient. Although the group that received intrathecal opioids experienced more intense analgesia than the other group, the groups did not differ in the incidence of major cardiovascular, respiratory and renal complications, nor did they differ in myocardial damage or infarction. The authors concluded that providing intense analgesia via neuraxial opioids, does not alter the combined major cardiovascular, respiratory and renal complication rate.