Continuous Epidural Morphine for Postoperative Pain Management after Gastric and Colorectal Surgery

Takahiko Fukuchi, Atsuyoshi Onitsuka, Masatomo Hayashi, Shoshi Senga, Yoshifumi Katagiri, Masatoshi Hayashi, Naoki Imai, Masaya Shibata, Kimi Yamauchi, Noaki Futamura, Yasuhiro Sumi, Hajime Hirose

First Department of Surgery, Gifu University Shool of Medicine

In order to determine the effectiveness and side effects of continous epidural morphine for postoperative pain management after gastric and colorectal surgery, a comparative study was made on 90 patients receiving continuous epidural morphine (Ep group) and 83 patients receiving a non-opioid intramuscularly or rectally when they required (non-Ep group). The Ep group was divided into two or three subgroups by age, dose and site of epidural catheter. The mean pain scores were 8.0 in the Ep group and 17.0 in the non-Ep group (p<0.001). Pruitus was present more frequently in the Ep group than in the non-Ep group (p<0.05) . There was no significant difference in the side effects between patients grouped by the dose of morphine. In patients over 74-year-old, the period without flatus in the Ep group was significantly longer than that in the non-Ep group. Respiratory depression in the thoracic epidural group was significantly more frequent than in the lumbar epidural group (15.4% vs 2.0%, p<0.05). Continuous epidural morphine was effective for postoperative pain management, and had no severe side effects. But we have to pay careful attention to the lateness of flatus in elder patients and respiratory depression in patients during thoracic epidural administration.

Key words
morphine, postoperative analgesia service, epidural anesthesia

Reprint requests
Takahiko Fukuchi Department of Surgery, Gifu University School of Medicine
40 Tsukasa-machi, Gifu, 500 JAPAN

Accepted
December 6, 1995

To read the PDF file you will need Abobe Reader installed on your computer.