A PROSPECTIVE STUDY OF EPIDURAL ANALGESIA WITH BUPIVACAINE AND MORPHINE IN POSTOPERATIVE PATIENTS

Abstract

Background: Epidural analgesia has been shown to be superior to intravenous analgesia for postoperative analgesia after thoracic, abdominal and lower extremity surgery. However it is unclear which opioid is optimal for epidural analgesia. Morphine has potential advantages, yet there was little to establish its efficacy and safety. Thus we prospectively monitored our patients receiving epidural analgesia with Bupivacaine combined with Morphine postoperatively.

Patients and Methods: A prospective study was conducted in 100 adult patients of either sex of age between 20 and 65 years belonging to ASA grade I and II. The study was conducted for relief of pain, amount of sedation and incidence of side effects like nausea, vomiting, pruritus and retention of urine in post operative patients receiving epidural analgesia when 0.125% Bupivacaine is combined with morphine. Lumbar epidural analgesia was initiated after central neuroaxial anaesthesia, with 0.125% Bupivacaine combined with 0.25mg/ml of morphine.

Results: The addition of Morphine to 0.125% Bupivacaine given epidurally resulted in good analgesia in the post operative period. It also yielded sedation, especially after the second dose with minimal minor side effects.

Conclusion: The addition of Morphine to Bupivacaine increases the duration of post-operative analgesia and it is more marked with the second top-up dose of Morphine and Bupivacaine.