A randomised, non-inferiority clinical trial of single-shot intrathecal morphine versus continuous wound infiltration for postoperative pain control after open pancreatoduodenectomy
Primary result · Mean coughing pain scoreResult — go to the resultMean difference −0.5 95% CI −1.1 to 0.2Authors' conclusion
ITM provides non-inferior overall and superior early analgesia to CWI after open pancreatoduodenectomy, although careful monitoring for early side effects is warranted.
Study context
- Population
- Adults undergoing elective open pancreatoduodenectomy; both groups received standardised multimodal analgesia and intravenous patient-controlled analgesia (IV-PCA)per-protocol population
- Participants
- 92 adults
- Comparison
- Single-shot intrathecal morphine vs continuous wound infiltration
- Primary endpoint
- Mean coughing pain score, averaged across 24, 48 and 72 h after surgery (non-inferiority margin 1.0)
- Follow-up
- 24, 48, and 72 h
Methodological detailsopen-label, non-inferiority, single-centre (tertiary hospital)
- Open-label
- Non-inferiority
- Single-centre (tertiary hospital)
Primary result
Mean coughing pain score · averaged across 24, 48, and 72 h
Mean difference
−0.5
95% CI −1.1 to 0.2
By group
Intrathecal morphine (ITM)
5.7
mean · SD 1.7
Continuous wound infiltration (CWI)
6.1
mean · SD 1.5
ITM vs CWI
mean difference −0.5 (95% CI −1.1 to 0.2)
As reported in the abstract
Secondary outcomes
Mean resting pain score
- ITM non-inferior to CWI
Pain scores at rest and on coughing · 2 h
- Significantly lower with ITM at 2 h, at rest and on coughing; sustained reduction on coughing at 24 h
IV-PCA fentanyl consumption
- Reduced with ITM
Original publication
A randomised, non-inferiority clinical trial of single-shot intrathecal morphine versus continuous wound infiltration for postoperative pain control after open pancreatoduodenectomy. Br J Surg. Published 6 July 2026. doi:10.
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