• Samuel Metz, Nanette Schwann, Wael Hassanein, Brian Yuskevich, and Todd Nixon.
• Department of Anesthesiology, Drexel University College of Medicine, Philadelphia, PA, USA. Samuel.Metz@Drexel.edu
• J. Cardiothorac. Vasc. Anesth. 2004 Aug 1; 18 (4): 451-3.

ObjectiveTo determine if preinduction intrathecal morphine is associated with successful intraoperative extubation in patients undergoing off-pump coronary artery bypass grafting.DesignA retrospective noncontrolled chart review of all patients undergoing off-pump coronary artery bypass grafting.SettingSingle university hospital.ParticipantsOne hundred twelve patients.InterventionsOne hundred twelve of 150 patients received preinduction intrathecal morphine as part of routine anesthetic care for off-pump coronary artery bypass grafting. Patients received a mean of 1.0 mg of intrathecal morphine (range 0.3-1.6 mg); average weight-corrected dose was 13.2 microg/kg (range 5-24 microg/kg).Measurements And Main ResultsThis study included intraoperative extubation rate, delayed respiratory depression, and other complications potentially attributable to intrathecal morphine. An intraoperative extubation rate of 77% was found. Five patients received naloxone postoperatively, 4 of them for delayed respiratory depression.ConclusionsIt is concluded that intrathecal morphine is associated with a high intraoperative extubation rate in patients undergoing off-pump coronary artery bypass grafting. The authors' practice included 24-hour respiratory monitoring to detect delayed respiratory depression.

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