Intermittent bolus versus patient-controlled epidural morphine for postoperative analgesia.
BACKGROUND
Patient-controlled epidural analgesia (PCEA) is a technique that combines the flexibility and convenience of PCA with the intrinsic analgesic efficacy of epidurally administered opioids. The aim of this study is to compare the analgesic and side effects of intermittent bolus injections of epidural morphine with PCEA using morphine during the first 24 h after elective low abdominal surgery.


METHODS
Sixty patients were randomly assigned into two groups. Patients in group I (n = 30) received 3 mg epidural morphine at an 8-hour interval after surgery. Patients in group II (n = 30) received 2 mg epidural morphine after surgery and patient-controlled analgesia device was processed to deliver morphine 0.15 mg/h, 0.15 mg/bolus. All patients were observed for pain relief and adverse effects for 24 h.


RESULTS
Mean morphine consumption was 9 mg for epidural morphine group and 6.87 +/- 0.27 mg for PCEA group. Although the PCEA group utilized significantly less morphine (p < 0.05), pain and sedation scores were similar in the two groups. Pruritus occurred more frequently in the epidural morphine group (63%) than in the PCEA group (33%). Frequency and severity of nausea and vomiting were similar in the two groups.


CONCLUSIONS
PCEA with morphine decreases morphine consumption and with less adverse effects than intermittent bolus of epidural morphine. PCEA with morphine is an acceptable alternative to epidural morphine after low abdominal surgery.
Tan
P H
PH
Department of Anesthesiology, Military 802 General Hospital, Kaohsiung, Taiwan, R.O.C.
Chia
Y Y
YY
Perng
J S
JS
Chou
A K
AK
Chung
H C
HC
Lee
C C
CC
D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010149:Postoperative Pain / Q000188:drug therapy*
D009020:Morphine