CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by WRITER, W.D. R.
Right arrow Articles by FORREST, J. B.
Right arrow Search for Related Content
PubMed
Right arrow Articles by WRITER, W.D. R.
Right arrow Articles by FORREST, J. B.

Canadian Journal of Anesthesia, Vol 32, 330-338, Copyright © 1985 by Canadian Anesthesiologists' Society

Epidural Morphine Prophylaxis of Postoperative Pain: Report of a Double-Blind Multicentre Study

W.D. R. WRITER MB FFARCS FRCPC1, J.B HURTIG MD FRCPC2, G. EDELIST MD FRCPC3, D. EVANS MB FRCPC4, G. S. FOX MD FRCPC5, R. E. NEEDS MB FRCPC6, C. E. HOPE MB FFARCS FRCPC7, and J. B. FORREST MD PHD FFARCS FRCPC8

1 Department of Anaesthesia, Grace Maternity Hospital, Halifax, Nova Scotia
2 Department of Anaesthesia, Ottawa Civic Hospital, Ottawa, Ontario
3 Department of Anaesthesia, Mount Sinai Hospital, Toronto, Ontario
4 Department of Anaesthesia, Toronto Western Hospital, Toronto, Ontario
5 Department of Anaesthesia, Royal Victoria Hospital, Montreal, Quebec
6 Department of Anaesthesia, Sunnybrook Medical Centre, Toronto, Ontario
7 Department of Anaesthesia, Victoria General Hospital, Halifax, Nova Scotia
8 Department of Anaesthesia, McMaster University, Hamilton, Ontario

Address correspondence to: Dr. W.D.R. Writer, Department of Anaesthesia, Grace Maternity Hospital, Halifax, Nova Scotia B3H 1W3.

In a double-blind placebo-controlled trial, 154 subjects, having intraperitoneal surgery or Caesarean section, and 53 patients undergoing lower limb orthopaedic surgery, received epidural morphine, 5 mg in 10 ml 0.9 per cent NaCl, or placebo, 10 ml 0.9 per cent NaCl, intraoperatively to determine duration of action and efficacy in preventing postoperative pain. Epidural morphine gave significantly longer postoperative analgesia (>11 h) than placebo (3-6 h) in both groups (p < 0.05) and patients who received morphine required less postoperative analgesic. Obstetric subjects experienced longer pain relief (18.3 ± 1.3 h) than patients undergoing non-obstetric intraperitoneal surgery (9.2 ± 1.2 h) (p < 0.001). Generally mild pruritus affected more than 40 per cent of those receiving morphine, but over 90 per cent of obstetric patients receiving morphine. Respiratory depression occurred in 2-7 per cent of subjects who received morphine; unpredictable in onset, it responded rapidly to naloxone. Epidural bupivacaine, if employed for the surgical procedure, appeared to prolong epidural morphine analgesia. We consider epidural morphine useful in preventing postoperative pain, but its use demands close observation of respiratory rate in a high density nursing area.

Key Words: ANALGESIA: postoperative • ANALGESICS: morphine • ANAESTHESIA: obstetric • ANAESTHETIC TECHNIQUES: epidural • PAIN: postoperative






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1985 by the Canadian Anesthesiologists' Society.