The Comparison of Effect of Epidural Morphine and of Morphine-Fentany1-Bupivacaine Mixtere for Analgesia Afrer Cesarean Section / 대한주산의학회잡지

ABSTRACT

The purpose of this study is to demonstrate a new postoperative analgesic which minimize the physiological changes of patients. Recently, it has become popular to administer opioids to epidural space rather than intravenously or by intramuscular administration. However, the side effects of opioids have limited the usefulness of this procedure. We tried to find out a way of providing postoperative analgesia while minimizing the side effects of opioids. This study has tested the effects of administering a mixture of small doses of morphine, fentanyl and bupivacaine and epidural morphine alone. The data of this study has taken from 20 paturients who have scheduled for cesarean section. We have classified into two groups which consist of 10 paturients each. We have administered epidural morphine alone to the first group and a small doses of morphine-fentanyl-bupivacaine mixture to second group. We have evaluated analgesic effects by comparing both groups' pain scores of the operative day and of the first postoperative day and evaluated such side effects as the degree of itching, nausea, vomiting, dizziness and respiratory depression by asking to paturients. This study has found the followings 1) Pain scores of the first group in the operative day and the first postoperative day are 1.2+/-0.4 and 0.4+/-0.5. The second group's pain scores are 0.2+/-0.4 and 0, and the second group's pain scores have significantly reduced (p<0.05). 2) Frequencies of such side effects as itching, nausea and vomiting are higher in the first group (8) than in the second group(4). In conclusion, small doses of morphine-fentanyl-bupivacaine mixture has demonstrated a more effective postoperative analgesia with minimum side effects in pain controlling after cesarean section than epidural morphine alone.