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KMID : 0613119940070010423
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Journal of St. Benedict Hospital
1994 Volume.7 No. 1 p.423 ~ p.427
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The Effect of Low Dose Bupivacation on Epidural Morphine Analgesia for Postoperative Pain
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하한수/Ha, Han Soo
박영철/김해규/백승완/정규섭/Park, Young Chul/Kim, Hae Kyoo/Baik, Seong Wan/Chung, Kyoo Sub
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Abstract
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Recently, epidural morphine has been administrated to decrease patients´ systemic stress responses such as: suffers, endocrine responses and impairment of pulmonary function, etc.
Epidural morphine provided excellent analgesic effect, but incomplete sensory blockade as compared to epidural local anesthetics, which has sympathetic blockade effect and tachyphylaxis.
Therefore, the authors surmised that low dose bupivacaine on low dose epidural morphine improved postoperative pain with greater sensory analgesia than epidural morphine alone.
The effect of low dose bupivacaine on epidural morphine analgesia for postoperative pain was evaluated in seventy patients. They were physical status I-III by ASA classification. Patients were randomly divided into 2 groups and they were administrated morphine 2.5 mg only (group I), morphine 2.5 mg plus 0.125 bupivacaine (group II) through epidural catheter I hour before the end of the operation.
During postoperative second days, their analgesic effects were evaluated by visual analogue scale (0-10). Side effects were also evaluated.
The results were as follows;
1) On the day of the operation, VAS score showed significant differences between two groups (morphine group 3.20±0.16, morphine plus bupivacaine group 2.77±0.08 ; p < 0.05).
2) On the postoperative and second day, there were no statistical differences between the groups according to VAS score.
3) The incidence of pruritus, nausea, and vomiting were no differences in both groups.
4) None of the patients showed objective sedation or a low respiratory rate ( <10 bpm).
We concluded that epidural administration of low dose bupivacaine on the epidural morphine analgesia was an effective method to decrease postoperative pain with little change in frequencies of side effects compared to epidural morphine alone.
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