J Korean Pain Soc.  2004 Dec;17(2):217-221. 10.3344/jkps.2004.17.2.217.

Postoperative Analgesic Effect of Combined Low Dose Intrathecal Morphine and Continuous Epidural Opioid Local Anesthetic Mixture after Lumbar Laminectomy

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, College of Medicine, Konyang University, Daejoen, Korea. kangpo1026@hanmail.net

Abstract

BACKGROUND
Epidural opioid-local anesthesia has been used for postlaminectomy analgesia. However, it sometimes has a poor analgesic effect in the early postoperative period. This study was designed to assess the postlaminectomy analgesic effect of combined low-dose intrathecal morphine and continuous epidural opioid-local anesthesia. METHODS: Seventy five patients, aged 40 70 years and scheduled for a lumbar laminectomy, were randomly allocated into three groups. The groups received either a single dose of 0 (saline injection) (n = 25), 0.1 mg (n = 25) or 0.2 mg (n = 25) intrathecal morphine, respectively, which was followed by continuous epidural fentanyl 5microgram/ml, morphine 50microgram/ml and 0.1% bupivacaine, at the rate of 2 ml/h. The visual analogue scale (VAS) was observed in the recovery room and 2, 4, 6, 12 and 24 h postoperatively; the side effects were also assessed. RESULTS: There were significant differences in the VAS scores between the intrathecal morphine groups and saline group and in the recovery room at 2 and 4 h between the intrathecal morphine 0.1 mg and 0.2 mg groups. The incidence of side effects increased in the intrathecal morphine groups. CONCLUSIONS: The combined low-dose intrathecal morphine and continuous epidural fentanyl-morphine-bupivacaine showed good analgesic effects after a lumbar laminectomy.

Keyword

epidural; intrathecal; lumbar laminectomy; morphine; postoperative analgesia

MeSH Terms

Analgesia
Anesthesia
Bupivacaine
Fentanyl
Humans
Incidence
Laminectomy*
Morphine*
Postoperative Period
Recovery Room
Bupivacaine
Fentanyl
Morphine
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