Journal of the Royal Society of Medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
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). ⋯ 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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As increasing numbers of recipients of renal allografts survive long term, complications of prolonged immunosuppression have become apparent. Of particular concern are the high rates of non-melanoma skin cancer (NMSC) and carcinoma of the cervix, vulva and perineum.