C.01: Intrathecal morphine following lumbar fusion: a randomized, placebo-controlled trial
Bibliographic record
Abstract
Background: Despite the ease of intraoperative injection, intrathecal morphine (ITM) is rarely provided in lumbar spine surgery. We therefore sought to demonstrate the safety and efficacy of ITM following lumbar fusion. Methods: In this double-blind trial, 150 patients undergoing elective instrumented lumbar fusion were randomly assigned to receive a single injection of ITM (0.2 mg) or placebo (saline) prior to wound closure. Primary outcomes were postoperative pain on the visual-analog scale during the inital 24 hours after surgery and respiratory depression. Secondary outcomes included related adverse events, opioid requirements, and length of stay. Outcome curves were estimated in an intention-to-treat, repeated-measures analysis. Results: Age, disability, operative times, and pre-operative pain were similar in both groups. ITM was associated with less pain both at rest (p<0.002) and with movement (p<0.02) during the initial 24 hours following surgery. ITM did not increase the cumulative incidence of respiratory depression (hazard ratio 0.86, p=0.66). While ITM reduced postoperative opioid requirements (p<0.03), there was no significant difference in length of stay (p=0.67). Adverse events did not significantly differ between groups. The early benefits of ITM on postoperative pain were no longer apparent after 48 hours. Conclusions: A single ITM injection safety reduces postoperative pain following lumbar fusion. (ClinicalTrials.gov NCT01053039)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.013 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".