Canadian Journal of Anesthesia, Vol 28, 523-529, Copyright © 1981 by Canadian Anesthesiologists' Society

Lumbar Epidural Morphine as an Effective Analgesic Following Cholecystectomy

¹ Department of Anaesthesia, University of Western Ontario, London, Canada
² Department of Anaesthesia, University of Western Ontario, London, Canada; Sir Charles Gairdner Hospital, The Queen Elizabeth II Medical Centre, Nedlands, W.Australia

Relief of pain with epidural morphine was evaluated in five patient subjects during two consecutive twenty-four hour periods after cholecystectomy. In one period, each subject received lumbar epidural morphine, first 4-6 mg, and twelve hours later, 2-3 mg; in the other period, epidural placebo at the same times. Except for four hours before each injection and twenty minutes thereafter, intramuscular morphine was administered as required throughout. The experiments were double-blind. Epidural morphine, unlike epidural placebo, reduced both a visual pain analogue score (p < 0.05) and a pain questionnaire score (p < 0.01) twenty minutes after injection. Epidural morphine compared to placebo reduced by one-half the total amount of narcotic (epidural plus intramuscular) administered over the twenty-four hour period (p < 0.05). Four of five subjects clearly preferred analgesia with epidural morphine over the effect of placebo plus therapeutic doses of intramuscular morphine. We conclude that epidural morphine, administered in this manner, is effective in relieving pain after cholecystectomy and that it may be preferred by patients over conventional intramuscular morphine.

Note:

Results of this study were presented at the meeting of The Canadian Anaethetists' Society at Toronto, June 1980.

Key Words: EPIDURAL MORPHINE • POSTOPERATIVE ANALGESIA