[Sexual differences in effects and side effects of epidural morphine for VATS (video-associated thoracic surgery)].
BACKGROUND
VATS (video-associated thoracic surgery) is mainly undertaken under general anesthesia only. Considering with patient's respiratory stability and postoperative pain relief, epidural anesthesia has advantages over general anesthesia. According to our clinical experience, side effects of epidural morphine, especially nausea and vomiting, often torture patients, especially woman.


METHODS
Epidural catheter was inserted before general anesthesia. Morphine 0-3mg was administered at the beginning of the operation and 0-4 mg was injected within 30hr after the operation. Effects and side effects of epidural morphine among 98 patients being operated by VATS were investigated backward with special attention to gender differences. The adverse effects noticed were thirst feeling, itching, nausea, vomiting and urinary retention. The use of rescue analgesics was also analyzed in each patient.


RESULTS
Among 68 men and 30 women, dosage of epidural morphine was not significantly different by gender. As for the side effects, the significant gender difference was observed only in nausea and vomiting, showing 46.7% in female and 16.2% in male (P= 0.07).


CONCLUSIONS
Statistically significant gender differences of effectiveness and side effects of epidural morphine in VATS were observed only in nausea and vomiting.
Kawagoe
Izumi
I
Department of Anesthesiology, Toranomon General Hospital, Tokyo 105-8470.
Sumida
Toshinobu
T
D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects*; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced* / Q000453:epidemiology*; D012727:Sex Characteristics; D020775:Thoracic Surgery, Video-Assisted
D009020:Morphine