Abstract
We investigated effects of epidural morphine on post operative pain and gastrointestinal tract in 49 gynecological patients who recieved laparotomy under epidural anesthesia. Morphine was injected in addition to 7 ml of normal saline epidurally when patient complained post operative pain. 25 patients were injected 2 mg of morphine hydrochloride (2 mg group), 12 patients 1 mg of morphine HCL (1 mg group), and 12 patients 0.5 mg of morphine HCL (0.5 mg group) . Postoperatively 2 mg group did not require any analgesics, but 25 % of 1 mg gnoup and 0.5 mg group required analgesics. The mean analgesic onset time was 28.4 minutes in 2 mg group, 43.8 minutes in 1 mg group, and 55.9 minutes in 0.5 mg group. The mean analgesic duration in 2 mg group was much longer than other morphine groups. Vomiting was observed in 36 % of 2 mg group, in 16 % of 1 mg group and 0.5 mg group respectively. As for the time to post operative initial flatus, these morphine groups did not differ significantly from other gynecological patient, recieved laparotomy under spinal anesthesia (n=25) or general anesthesia (n=25) . Respiratory or hemodynamic depression was not observed in morphine group. Consequently, we considered that 2 mg of epidural morphine may serve more excel-lently as the post operative pain reliever than other dose (1 mg, 0.5 mg) of morphine, and epidural morphine (less than 2 mg) did not inhibit the action of bowel clinically.
