A Comparison of the Analgesic and Side Effects of Continuous Epidural Morphine and Nalbuphine for Postoperative Pain / 대한마취과학회지

ABSTRACT

BACKGROUND: A number of recent reports have described the usefulness of the epidural injection of narcotics for the relief of postoperative pain. Morphine, a u-receptor agonist, produce strong analgesic effect with some side effects. Nalbuphine, is a u-antagonist and k-agonist, has an analgesic effect comparable to morphine with little side effects. METHOD: We divided 60 patients into 3 groups utilizing the five-day Baxter Infusor in 0.125% bupivacaine at 0.5 ml/hr 1) Group M (n=20) received initial 2 mg of bolus + 2 mg/day of maintenance morphine 2) Group N(n=20); initial 4 mg of bolus + maintenance 8 mg/day nalbuphine 3) Group M+N(n=20); initial 2 mg morphine of bolus + maintenance 8 mg/day nalbuphine. Analgesic effect was evaluated by visual analogue scale(0-10) at 6, 12, 18, 24 and 48 hour postoperatively. Changes in blood pressure, heart rate, and incidence of side effects were observed. RESULTS: No significant hemodynamic changes were seen in any of the groups. The patients of group M and M+N get less pain than group N but side-effects of group M were significantly more than group N, M+N. CONCLUSIONS: Nalbuphine hydrochloride could be better agent than morphine in terms of complication and the dose of group M+N (initial morphine 2mg of bolus + maintenance 8 mg/day nalbuphine) may be recommended for postoperative analgesia.