Acute postoperative pain following elective open colorectal cancer resection surgery, including inadequate pain control, opioid-related adverse effects, and optimization of neuraxial analgesia techniques Intrathecal morphine, Epidural analgesia, Colorectal cancer surgery, Postoperative pain, Pain management, Neuraxial analgesia, Opioid consumption, Patient satisfaction, Randomized controlled trial
Conditions
Interventions
Patients in this arm receive intrathecal morphine 0.2mg (preservative-free) administered via spinal needle at L3-4 or L4-5 interspace before induction of general anesthesia. Following surgery, patient
Active Comparator Procedure/Surgery,Active Comparator Procedure/Surgery
Intrathecal Morphine (ITM),Epidural Analgesia (EPI)
Sponsors
None listed
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1.Age 18-75 years 2.ASA physical status I-III 3.Diagnosed with colorectal cancer requiring surgical resection 4.Scheduled for elective open colorectal surgery under general anesthesia 5.Able to understand and use Visual Analog Scale (VAS) for pain assessment 6.Able to provide written informed consent 7.Willing to comply with study protocol and follow-up procedures
Exclusion criteria
Exclusion criteria: 1.Patient refusal to participate in the study 2.Inability to provide informed consent 3.Emergency or urgent surgery 4.ASA physical status IV-V 5.Contraindications to neuraxial anesthesia: 6.Allergy or contraindications to study medications: 7.Known hypersensitivity to morphine, bupivacaine, or fentanyl 8.Allergy to other opioids or local anesthetics 9.Chronic pain conditions: 10.Chronic opioid use (regular opioid use >3 months) 11.Opioid tolerance or dependence 12.Current pain medication exceeding oral morphine equivalent >30 mg/day 13.Inability to understand Thai or English language for pain assessment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Postoperative pain intensity at rest 48 hours after surgery Visual Analog Scale (VAS) pain score at rest at 48 hours postoperatively,Time to first analgesic request 0-48 hours postoperatively Duration from end of surgery to first analgesic request | — |
Secondary
| Measure | Time frame |
|---|---|
| Cumulative postoperative morphine consumption 0-24 hours and 0-48 hours postoperatively Total morphine consumption (in mg) at 24 and 48 hours | — |
Countries
Thailand
Contacts
Public ContactHadchaporn kheawbanyang
Phichit hospital
Outcome results
None listed