The Clinical Study of Epidural Morphine on the Postoperative Pain / 대한마취과학회지

ABSTRACT

Thirty two patients wha had undergone operations were given a slow extradural narcotic injection. Patients were divided into three groups: First Group: extradural administration of pentazocine 30 mg to 10 adult patients. Second Group: extradural administration of pethidine 50 mg to 10 adult patients. Third Group: extradural administration of low-dose morphine(2 mg) in 10 ml of poysiologic saline to 12 adult patients. The epidural catheter had been left in situ and the patients instructed to request further analgesia in the postoperativly as neded. All case had considered amelioration of pain which became evident with in 2 to 15 minutes and was effective from 1 hour to complete relieve. They had also received an intramuscular injection of atropine sulfate(0.01 mg/kg) and valium (0.2 mg/kg) for premedication 30 minutes prior to sending to the operating room. The conclusions are as follows: 1) The morphine(2 mg) administered by continuous epidural injection is superior to other groups for relief of pain. It suggested that analgesic effect was concerned with drug dosage (Table 4). 2) Third group(morphine) was signficantly higher than other groups in statistical mean analgesic score analysis compared with the other groups. It suggested that significantIy high analgesic score was concerned with the pharmacologic action of the drug effect. 3) Before and after epidural injection of drugs, a statistical pulse change in the second group was significant but the other vital sign changes in all the group was not significant (Table 7). It suggested that significant pulse change was concerned with direct drug action and operative stress. 4) The subject requires study for mechanism, adverse effect and its prevention of narcotic administration in epidural space. Consequently it is suggested that continuous epidural injection of pethidine or' pentazoine is the optimum method of postoperative pain relief, only that when morphine is given, contin-uous epidural injection should be the method of choice.