Saddle Block With IT Morphine for Postoperative Pain

This trial explores a new method to manage pain after penile inversion vaginoplasty, a specific gender-affirming surgery. Researchers aim to determine if adding a saddle block with intrathecal (spinal) morphine can reduce severe post-surgery pain. Participants will receive either this new pain management method or a standard care plan. The trial seeks individuals who have undergone or plan to undergo penile inversion vaginoplasty and have not been using high doses of pain medication regularly. As an unphased trial, it offers participants the chance to contribute to innovative pain management strategies for gender-affirming surgeries.

The trial does not specify if you need to stop taking your current medications. However, if you are using over 30mg of oxycodone or its equivalent per day, you would not be eligible to participate.

Studies have shown that intrathecal morphine effectively relieves pain, particularly for surgeries on the lower body, such as knee or hip replacements. Notably, this pain control method does not increase the risk of breathing problems, a common concern with opioid use. Research indicates that a dose of up to 100 micrograms of morphine is generally safe for patients.

Researchers are excited about the treatment using a saddle block with intrathecal morphine for postoperative pain because it offers a unique approach to pain management. Unlike standard treatments that typically involve general systemic analgesics like acetaminophen, NSAIDs, and opioids, this method targets pain directly at the spinal level through the intrathecal space, potentially providing more effective and localized pain relief. Additionally, the use of intrathecal morphine, a potent pain reliever, may reduce the need for higher doses of systemic opioids, minimizing their side effects. This innovative delivery method could enhance recovery and improve comfort for patients after surgery.

Research has shown that using a saddle block with spinal morphine can help manage post-surgical pain. In this trial, participants in the "Saddle block with intrathecal morphine Group" will receive an injection of bupivacaine combined with spinal morphine. Studies have found this combination reduces pain both during and after the procedure. This type of pain relief can also decrease the overall need for pain medications. Previous studies suggest that combining bupivacaine, a numbing medicine, with spinal morphine provides better pain control, indicating its effectiveness for managing pain after penile inversion vaginoplasty.¹⁶⁷⁸⁹