การใช้มอร์ฟีนทางเอปิดูราลเพื่อระงับปวดหลังผ่าตัด

บทคัดย่อ

Objective:  To evaluate the analgesic effect, side effects and complications of epidural morphine in postoperative pain within relief.

Study design :  Descriptive study.

Method:  85 patients scheduled for various types of surgery received epidural morphine for treatment of postoperative pain within twenty-four hours after the operation, pain scores were recorded both at rest and on movement. Side effects including nausea, vomiting, pruritus and respiratory depression were also recorded.

Result:  Ninety-six percent of patients felt no or mild pain at rest, whereas 51% felt similar degrees of pain on movement. Orthopedic patients, in particular, had lower pain scores both at rest and on movement than other groups. Nausea, vomiting and pruritus were found in 35%, 26% and 73% of the subjects respectively. Three patients developed hypotension within  the first postoperative day. Respiratory depression did not occur in this study. However, one patient developed total spinal block after epidural block.

Conclusion:  In this study, epidural morphine or mixed with a local anesthetic was a good choice for postoperative pain relief especially at rest. Nevertheless, the physician should beware of complications from epidural block and epidural morphine.