Korean J Anesthesiol.  1997 Apr;32(4):588-591. 10.4097/kjae.1997.32.4.588.

There is not Different Between the Patient-Controlled Lumber Epidural and Thoracic Epidural Analgesia with Morphine for Postthoracotomy Pain

• Han JU
• Shin YS
• Kim JE
• Lee JS
• Shim KD

• KMID: 1934618
• DOI: http://doi.org/10.4097/kjae.1997.32.4.588

Abstract

BACKGROUND
With different injection levels, the dose-requirements of epidural opioids association with lipid solubility are controversial. The purpose of this study was to compare the effect of patient controlled lumbar(L group) and thoracic(T group) epidural morphine on dose-requirements, analgesia and side effects after thoracotomy.
METHODS
Twenty patients were randomly assigned into one of two groups. Before the induction of general anesthesia, the epidural taps with 17G with Tuohy needle were done on the 6th or 7th thoracic and 2nd or 3rd lumbar intervertebral levels, respectively. The epidural catheter tips were placed 3~4 cm above the needle tips in either groups . Morphine 3 mg in 3 ml normal saline was administered via the epidural catheter in all the patients immediately at the end of surgical manipulation. PCA/basal infusion dose and lockout interval was 0.02 mg/once, 0.08 mg/hr and 5min respectively. After the initial dose dose-requirements were checked at 4, 8, 24 and 48hour and pain was assessed on visual analogue scale at 1, 4, 8, 24 and 48hour. Side effects were observed.
RESULTS
There were no significant difference between groups in the dose-requirements of morphine, their analgesia and side effects.
CONCLUSIONS
Lumbar epidural morphine provides postoperative analgesia after thoracotomy that is clinically indistinguishable from that provided by thoracic epidural morphine with respect to dosage, quality of analgesia and side effect.

Keyword

Analgesia; patient-controlled analgesia; Analgesics; morphine; Anesthetic technique; epidural; Surgery; thoracotomy

MeSH Terms

Analgesia
Analgesia, Epidural*
Analgesia, Patient-Controlled
Analgesics
Analgesics, Opioid
Anesthesia, General
Catheters
Humans
Morphine*
Needles
Solubility
Thoracotomy
Analgesics
Analgesics, Opioid
Morphine