Pulmonary complications after intrathecal morphine administration: a systematic review and meta‐analysis with meta‐regression and trial sequential analysis
Authors' conclusion
There is moderate evidence that intrathecal morphine does not increase rates of sedation or hypoxaemia after non-obstetric surgery. There is very low-quality evidence that intrathecal morphine might increase the rate of respiratory depression.
Study context
- Population
- Patients undergoing any non-obstetric surgery under GA or spinal anaesthesia
- Participants
- 7,388 patients · 127 trials
- Comparison
- Intrathecal morphine vs control
- Outcome
- Rates of postoperative sedation, respiratory depression and hypoxaemia
Methodological detailsmeta-regression, trial sequential analysis
- Meta-regression
- Trial sequential analysis
Pooled result
As reported in the abstract
Intrathecal morphine vs ControlOdds ratio (95% CI)P value
Sedation; moderate quality evidence
1.00(0.78–1.28)
P = 0.98Hypoxaemia; moderate quality evidence
1.22(0.84–1.79)
P = 0.30Respiratory depression; very low-quality evidence
1.78(1.19–2.67)
P = 0.005Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Respiratory depression, excluding morphine doses > 500 μg | 1.49 (0.99–2.23) | P = 0.06 | |
| 0.512Odds ratio (log scale) |
Dose–response (meta-regression)
- Associations between dose and rate of sedation, respiratory depression and hypoxaemia; not persisting when doses > 500 μg excluded
Trial sequential analysis
- Further data may still be required for all outcomes; statistical significance reached for respiratory depression
Original publication
Pulmonary complications after intrathecal morphine administration: a systematic review and meta‐analysis with meta‐regression and trial sequential analysis. Anaesthesia. Published 16 April 2025. doi:10.
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