Intrathecal morphine is as effective as continuous wound infiltration for pain management after open pancreatoduodenectomy.

• In a study of 92 patients, intrathecal morphine had a mean coughing pain score of 5.7 vs. 6.1 for continuous wound infiltration.
• It provided better early pain relief, significantly reducing pain scores at 2 hours post-op and sustaining lower scores through 24 hours.

Surgeons should consider intrathecal morphine for its effective pain control, but monitor for potential early side effects like respiratory depression and pruritus.