title: Effect of epidural morphine on sedation requirements during regional anesthesia.
abstract: OBJECTIVE
  To examine the effect of using analgesic doses of epidural morphine on midazolam requirements for conscious sedation during regional anesthesia.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled trial.
  
  
  METHODS
  Operating rooms at a university hospital.
  
  
  METHODS
  20 ASA physical status II and III patients aged 50 to 70 years undergoing elective peripheral vascular reconstruction with epidural anesthesia.
  
  
  METHODS
  At the beginning of surgery, 10 patients received 3 mg of epidural morphine, and the other 10 patients received normal saline epidurally. All patients received midazolam intravenously in bolus doses and as a continuous infusion to maintain a steady state of sedation throughout surgery.
  
  
  RESULTS
  There was no difference between the dose of midazolam required to maintain sedation in the two groups during the first 3 hours of the study. Beyond the third hour, the midazolam dose required to maintain the same level of sedation was significantly higher in the placebo group than in the epidural morphine group (p = 0.05).
  
  
  CONCLUSIONS
  An analgesic dose of epidural morphine, after a latent period of 3 hours, may decrease the dose of midazolam required for sedation using regional anesthesia.
authors.affiliation: Department of Anesthesia, Georgetown University Medical Center, Washington, DC 20007.
authors.forename: M S
authors.initials: MS
authors.lastname: Hannallah
authors.forename: D J
authors.initials: DJ
authors.lastname: Mundt
mesh_terms: D000368:Aged; D000765:Anesthesia, Conduction; D000767:Anesthesia, Epidural; D016292:Procedural Sedation; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008874:Midazolam; D008875:Middle Aged; D009020:Morphine
chemical_list: D009020:Morphine; D008874:Midazolam