• Hsin-Lun Wu, Mei-Yung Tsou, Pei-Wen Chao, Su-Man Lin, Kwok-Hon Chan, and Kuang-Yi Chang.
• Department of Anesthesiology, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taiwan, R.O.C.
• Acta Anaesthesiol Taiwan. 2010 Jun 1; 48 (2): 75-9.

BackgroundTo evaluate the association between daily morphine requirement and the intravenous patient-controlled analgesia (IVPCA) setting in patients undergoing spinal surgery.MethodsWe conducted a retrospective analysis of 179 patients of American Society of Anesthesiologists physical status class I-III who underwent elective posterior lumbar spinal surgery and consented to IVPCA for postoperative pain control. The regi-mental solution contained morphine 1 mg/mL. The IVPCA program was set to deliver a priming dose of 1.5-4 mL, a basal infusion rate of 0-1.2 mL/hr, and a 0.5-1.5 mL bolus on demand with a 5-minute lockout interval. Demographic data, surgical procedures, analgesia program setting variables, 4-hour cumulative morphine dose and 11-point numeric rating scale for pain on postoperative days 1 and 2 were collected for comparison.ResultsThe IVPCA requirement decreased gradually over time (p < 0.001). The number of vertebrae involved significantly influenced the daily morphine requirements (p = 0.01). None of the IVPCA settings, including continuous infusion, affected daily morphine requirements. On average, the analgesic requirement on postoperative day 2 was 18% less than that on postoperative day 1.ConclusionThe number of vertebrae involved was significantly associated with the daily IVPCA requirement. The IVPCA settings, including priming dose, basal infusion rate and bolus dose, did not affect the daily morphine requirements.2010 Taiwan Society of Anesthesiologists. Published by Elsevier B.V. All rights reserved.

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