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Korean Journal of Anesthesiology 2000;39(1):45-50.
DOI: https://doi.org/10.4097/kjae.2000.39.1.45   
The Effect of Epidural Lidocaine Infused with Morphine on Pain and Bowel Motility after Hysterectomy.
Young Kyun Choe, Seong Min Oh, Jeong Hun Kim, Soon Ho Cheong, Young Jae Kim, Jin Woo Park, Chee Mahn Shin, Hyo Seong Park, Ju Yuel Park
Department of Anesthesiology, College of Medicine, Inje University, Paik Hospital, Pusan, Korea.
Abstract
BACKGROUND
Postoperative ileus is considered to be caused by the activation of spinal reflexes originating from the abdominal cavity with the sympathetic nerves as the efferent nerves. Epidural anesthesia as a perioperative adjunct has been shown to provide superior pain control, and has been implicated in more rapid postoperative ileus resolution possibly through a sympathetic block mechanism. This study was undertaken to compare the effects of epidural morphine-lidocaine with those of epidural morphine alone on postoperative bowel motility and pain.
METHODS
Forty-four ASA I or II women scheduled for transabdominal hysterectomy were considered for the study. They were randomly allocated to one of two groups. Group M (n = 22) received postoperative epidural morphine 16 mg by infusion pump, 2 ml/h, for 2 days, group ML (n = 22) received morphine 16 mg plus 0.42% lidocaine by infusion pump, 2 ml/h, for 2 days. Both group received morphine 4 mg in 0.5% lidocaine 8 ml epidurally as a single bolus when the peritoneum was closed. Postoperative pain, and the time interval from termination of operation to the first passage of flatus were checked RESULTS: In group ML, the times for first passing of flatus (33.4 +/- 10.5 h; mean +/- SD) and visual analogue scale score (0.3 +/- 0.6) were significantly shorter and lower than in group M (flatus 42.6 +/- 8.4 h and VAS score 1.3 +/- 1.7).
CONCLUSIONS
The epidural lidocaine infused with morphine demonstrated earlier recovery of bowel motility and better postoperative pain relief than the epidural morphine alone.
Key Words: Analgesia: epidural; postoperative; Gastrointestinal tract: motility; postoperative; Pharmacology: lidocaine; morphine


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