Abstract
Effects of intrathecal morphine on postoperative pain and complications were studied in 75 patients who received gynecological laparotomy under spinal anesthesia. On spinal anesthesia, 50 patients were injected intrathecally, 0.3% dibucaine with 0.5mg of morphine HCl as morphine group, and 25 patients were injected intrathecally with 0.3% dibucaine only as a control group. Postoperatively, 50% of the morphine group did not require analgesics, but 96% of the control group required analgesics. Except for the patients who did not require analgesics, the mean analgesic duration was 27.3 hr in morphine group, 6.1 hr in control group. Analgesics, used postoperatively, were indomethacin (suppository) and pentazocine (injection) . 72% indomethacin in the control group, 42% in morphine group, and 88 % pentazocin was used in the control group, 14 % in morphine group. The dose of both analgesics used in morphine group was significantly less than that used in control group (p<0.05) . No patients showed severe respiratory depression. Nausea was observed in 48% of the control group, 32% in morphine group. Vomitting was observed in 28% of the control group, 22 % of the morphine group. As for the time to postoperative initial flatus, there was no significant difference between control group and morphine group. After postoperative 4 day's bladder catheterization, no patients developed urinary retention. From these results, when gynecological laparotomy was scheduled under spinal anesthesia, intrathecal injection of dibucaine with 0.5 mg morphne was recommended for the postoperative pain.
