Epidural morphine analgesia. Postoperative period
Zenz, M.; Piepenbrock, S.; Otten, B.; Otten, G.; Neuhaus, R.
Der Anaesthesist 30(2): 77-82
1981
ISSN/ISBN: 0003-2417 PMID: 7224134 Document Number: 171023
50 patients after abdominal surgery received peridural morphine for postoperative pain relief. At the end of operation, 2-3 mg morphine in 10-15 ml 0,9% saline were injected peridurally by a catheter, which was placed preoperatively. The injection was followed by a dissociated analgesia. Diffuse pain and wound pain were diminished. Pin prick and temperature were still perceived. Analgesia started within 2-5 min after injection and lasted 14 h in the mean (range 1-49 h). The degree of analgesia was determined by a visual analogue scoring system. The patients reported a marked pain relief. A new dose of 2 mg morphine was given on demand, when the patients felt pain again. This procedure was continued until the second postoperative day. The overall amount of morphine by peridural application was 8 mg within 3 days. Neither clinically nor by blood gas analyzes here were signs of respiratory depression. There were no severe side effects. The advantages of epidural morphine analgesia are: low dose, long duration, lack of sedation and motor block, lack of respiratory depression, tachyphylaxia and sympathetic block. No pneumonia were seen in the epidural morphine group, whereas 4 cases of pneumonia were seen in the control group (n = 50) with conventional analgetics.