Overview
The goal of this clinical trial is to learn the clinical and cost effectiveness of intrathecal morphine (ITM) in addition to usual care as a postoperative pain relief strategy following major laparoscopic abdominal surgery compared with current usual care. The main questions it aims to answer are:
An enhanced analgesic technique, consisting of ITM in addition to usual care , improves the postoperative quality of recovery at day 1 after surgery by at least 6 points on the 15-item quality of recovery questionnaire (QoR-15) compared to usual care alone, in patients undergoing major laparoscopic abdominal surgery?
Researchers will compare ITM + Usual care to Sham ITM + Usual Care (The sham ITM mimics the ITM procedure, but the dura is not breached) to see if ITM works to postoperative pain relief.
Participants will:
Receive ITM + Usual care or Sham ITM + Usual care on surgery day Have interview with outcome assessors and complete the CRFs on the day of surgery, postoperative day 1, day 2, day 3 and up to postoperative day 30
Eligibility
Inclusion criteria:
* Age 18 years or over AND able to give informed consent (with interpreters provided where necessary)
* Elective (i.e., planned) laparoscopic or robotic abdominal surgery within one or more of the following specialties:
* Colorectal
* Gynaecology
* Hepato-biliary (including pancreatic surgery)
* Upper gastrointestinal
* Urology/Renal
* Anticipated duration of surgery ≥ 2 hours (from knife-to-skin to end of wound closure)
* Anticipated hospital stay ≥ 24 hours (from the end of surgery)
Exclusion criteria:
* Allergy to study drugs
* Anatomical factors making intrathecal injection impossible
* Anticipated requirement for postoperative invasive ventilation
* American Society of Anesthesiologists (ASA) Score \