Clinical Study of Postoperative Pain Relief after Regional Anesthesia with a Small Dose of Morphine . |
Kwang Jin Moon, Kyung Ho Hwang, Yong Ae Chun, Wook Park, Sung Yell Kim |
Department of Anesthesiology, Soon Chun Hyang College, School of Medicine, Seoul, Korea. |
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Abstract |
In an attempt to relieve postoperative pain after lumbar epidural anesthesia, a small dose of morphine with lidocaine was administered into the lumbar epidural space. It is suggested that the morphine reaehed the subarachnoidal space and produced its effect by direct action on the specific opiate receptors in the substantia gelatinosa of the posterior horn of the spinal cord. Epidural anesthesia was done in l25 cases from June 1979 through March 1980. These cases were divided into two groups (Control group and Morphine group). The Control group was 46 cases which were injected with 2% lidocaine, and the Morphine group was 79 cases which west injected with 2% lidocaine and morphine (3.
5~6. 5mg). 0.1% epinephrine 0.1mL was mixed to each 10ml of 2% lidocaine in all of both groups, The results of this study were as follows: 1) The cases complaining pain within 12 hours after epidural anesthesia were 36/46(78.2 %) in the Control group and 11/79(13.9%) in the Morphine group. 2) A variable single dose of morphine did not affect the duration of postoperative pain relief. 3) The time of recovery of spontaneous voiding was similar in Control and Morphine groups. Within 24 hours, spontaneous voiding was recovered in 34/46(73,9%) of the Control group and in 64/79(81.0%) of the Morphine group. 4) Blood pressure changed a little within 30 minutes after epidural anesthesia in both groups(56.5% in the Control group and 54.4% in the Morphine group). 5) Complications were similar in both groups except for nausea and vomiting, which occurred more in the Morphine group(8.9% & 7. 6) than in the control group (4.4% & none). |
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