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KMID : 0388719940010020216
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Journal of Korean Society of Spine Surgery
1994 Volume.1 No. 2 p.216 ~ p.222
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The Effect of Epidural Morphine for Pain Management after Spinal Surgery
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Shin Byung-Joon
Park Jae-Min
Kim Yun-Il
Park Wook
Choi Chang-Wook
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Abstract
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Postoperative pain is a serious problem to both surgical team and patients. For reduction of this pain, numerous methods are used. Of these methods intramuscular injection of analgesics including morphine is generally utilizing method with
systemic effects. But sometimes this systemic use is not seen satisfying results because of inappropriate dosage afraid of side effects. In recent years. Considerable interest has been focused on the newer techniques of postoperative pain control. The use of epidural morphine for postoperative pain control has been extensively described and there have been numerous report on its efficacy.
Authors compared the effects of epidural morphine with that on IM injection for postoperative pain management after spinal surgery. 48 patients that had been operated were divided in two groups. Study group. 30 patients, were controlled with
epidural morphine and control group. 18 patients, were controlled with IM injection.
From this study, we obtained following results.
1) In study group. pain score was lower than that of control group for follow up day.
2) The pain was reduced rapidly for postoperative 2-3 day at both groups.
3) The average amounts of morphine was lower in study group(5.73 mg versus 22.22 mg).
4) The frequency of side effects were similar except for itching and nausea. Itching and nausea were more frequent in study group. In conclusion, we found several advantages of epidural injection of morphine compared with IM injection. First, epidural injection of small doses of morphine gives satisfactory analgesia Second. Severe pain associated with surgery commonly extendeds to second or third postoperative day so, it is not necessary to use for long term. Third, because of small doses and short term injection of morphine. Serious side effects were not found. Lastly. Since the epidural space is readily available during the operation, the use of epidural morphine in patient undergoing spinal surgery is easy. Safe and effective method.
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