Abstract
Epidural morphine analgesia was assessed in 134 patients after upper abdominal surgery under neuroleptanaesthesia (NLA), modified NLA and GOF. Two and 3 mg of morphine were given before surgery through an indwelling epidural catheter. After surgery, satisfactory analgesic effect was obtained in more than 80% of all the patients.
Duration of action was slightly longer in the group which received 3 mg of morphine (mean 27.3h) than in the group which received 2mg of morphine(mean 21h). The analgesic effect of epidural morphine was excellent both in elderly patients and in patients less than 160 cm tall.
Arterial blood gas was measured both before and after surgery, and the values for blood gas analysis showed statistically significant elevation of Paco2 postpoeratively. In modified NLA group, 2 mg of morphine was unsatisfactory to relieve postoperative pain. The values for blood gas analysis, however, showed significant respiratory depression in the early postoperative period.
It is concluded that under neuroleptanaesthesia, preoperative administration of epidural morphine 2 mg, gives satisfactory postoperative analgesia of long duration with minimal side effects.
