A Review of the Intrathecal Opioids’ Effect on Hemodynamic Changes and Spinal Anesthesia Quality in Femoral Surgeries

Karami, Nazli; Hassani, Ebrahim; Mahoori, Alireza; Afshar, Ahmadreza

doi:10.22034/ijos.2025.543405.1143

A Review of the Intrathecal Opioids’ Effect on Hemodynamic Changes and Spinal Anesthesia Quality in Femoral Surgeries

Document Type : Review

Authors

Nazli Karami ¹ ^¶

Ebrahim Hassani ²

Alireza Mahoori ²

Ahmadreza Afshar ³

¹ Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

² Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

³ Department of Orthopedics, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

https://doi.org/10.22034/ijos.2025.543405.1143

Abstract

Intrathecal opioids, such as morphine and fentanyl, are increasingly being used as adjuncts to spinal anesthesia and improve the quality of pain relief during and after surgery. This review investigates the mechanisms, benefits, and side effects of using these opioids, particularly in the context of femoral surgeries. The pharmacokinetics of these agents, including their rapid distribution in cerebrospinal fluid and binding to spinal receptors, contribute to effective pain management but also carry risks such as respiratory depression and urinary retention. Additionally, the impact of hemodynamic changes in femoral surgery is reviewed, emphasizing the importance of carefully adjusting anesthetic regimens and close postoperative monitoring to minimize complications. Evidence suggests that intrathecal opioids may reduce the incidence of postoperative delirium and opioid consumption in elderly patients, although further research is needed to confirm their efficacy in various surgical settings. This review underscores the need for more research into multimodal pain control using intrathecal opioids.

Keywords

Intrathecal opioids

spinal anesthesia quality

hemodynamic changes

femoral surgery

Subjects