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KMID : 0381219810130010079
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Journal of RIMSK
1981 Volume.13 No. 1 p.79 ~ p.85
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The Analgesic Effects of Morphine Sulfate
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Abstract
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In recent animal experiments, opiate receptors were identified autoradiographically in the brain and the substantia gelatinosa of the spinal cord. In a corollary study, morphine administered directly into the spinal subarachnoid space of the rat produced potent analgesia.
Also, an opiate-like analgesic effect was reported to occur after the injection of methionineenkephalin (Met-enkephalin) and its analogs. The results of these animal experiments prompted us to study the effect of intrathecally applied morphine in patients.
Morphine sulfate 0.3mg dissolved in a 0.9% saline solution up to 0.1°,6 was administered into the lumbar subarachnoid space prior to general anesthesia in 5 patients undergoing surgical operations and 0.25mg into the lumbar subarachnoid and 2mg into the epidural spaces in 5 and 8 patients respectively with intractable pain. Also, the analgesic effects of morphine sulfate and local anesthetics were analyzed in 11 patients of spinal anesthesia, 9 patients of caudal anesthesia, 8 patients of brachial block and 1 patient of intravenous regional anesthesia. The analgesic effects of intravenous and intramuscular morphine sulfate 10mg and placebo (normal saliine lml, i.v.) were measured with "\TSPS" (visual selfscoring pain scale) designed by authors for the fundamental experiments.
Small doses of morphine sulfate given epidurally, subarachnoidally, intravenously, and intramuscularly were reported, with the following results (mean -SD) : intravenous morphine; pain reduction rate 70^-80% of control values, duration 3-4 hours, intramuscular morphine; pain reduction rate 40-57% of control values, duration 3-.-4 hours, subarachnoidal morphine in spinal anesthesia and caudal anesthesia; duration 35.03±-27.65 (23---72 hours) and 26.84+ 26.95(1.33-72 hours) respectively, subarachnoidal morphine in general anesthesia; pain reduction rate 80-90% of control values, duration 29.96_16.44 hours, subarachnoidal morphine and epidural morphine in intractable pain; pain reduction rate 80.90%% of control values in Loth, duration 26.87±9.03 and 24.21±21.84 hours respectively.
This intrathecal administration of small doses of morphine prior to an operation or synchronized with local anesthetics in regional anesthesia should be seriously considered as a new adjunct to anesthesia and as a methcd of relieving post-operative pain and intractable pain.
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