Epidural morphine provides postoperative pain relief in peripheral vascular and orthopedic surgical patients: A dose-response study

P. D. Allen, T. Walman, M. Concepcion, M. Sheskey, M. K. Patterson, D. Cullen, B. G. Covino

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

A randomized double-blind study compared the dose-response relationship of epidural morphine for postoperative pain relief in two groups of patients whose surgical procedures would result in either moderate (femoral-popliteal bypass) or severe (total knee replacement) postoperative pain. Preservative-free morphine sulphate in doses of 0, 2, 5, or 10 mg in a volume of 10 ml saline were administered via lumbar epidural catheters. The epidural morphine was administered 1 hr after the last dose of intraoperative local epidural anesthetic in an effort to achieve a pain-free postoperative course. A significant relationship existed between the dose of epidural morphine and both time to first required pain medication and 24-hr weighted pain score. Five mg epidural morphine provided significant improvement in postoperative analgesia compared with the control in both groups. Further enhancement of analgesia occurred with 10 mg; however, late respiratory depression, demonstrated by an increased resting PaCO2 10 hr after administration, was seen only with the 10-mg dose in both surgical groups. Minor complications such as nausea, vomiting, pruritus, and urinary retention were uncommon and did not appear to be related to dose. We found that 5 mg epidural morphine provided long-lasting postoperative analgesia without serious adverse effects after peripheral vascular and orthopedic surgery.

Original languageEnglish (US)
Pages (from-to)165-170
Number of pages6
JournalAnesthesia and Analgesia
Volume65
Issue number2
StatePublished - 1986
Externally publishedYes

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Allen, P. D., Walman, T., Concepcion, M., Sheskey, M., Patterson, M. K., Cullen, D., & Covino, B. G. (1986). Epidural morphine provides postoperative pain relief in peripheral vascular and orthopedic surgical patients: A dose-response study. Anesthesia and Analgesia, 65(2), 165-170.