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Postoperative Pain Treatment after Upper Abdominal Surgery with Epidural Morphine at Thoracic or Lumbar Level
Author(s) -
Larsen V. Højkjær,
Iversen A. D.,
Christensen P.,
Andersen P. K.
Publication year - 1985
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1985.tb02255.x
Subject(s) - medicine , anesthesia , morphine , lumbar , vital capacity , pulmonary function testing , cardiothoracic surgery , surgery , laparotomy , visual analogue scale , lung function , lung , diffusing capacity
Thirty patients undergoing upper laparotomy were entered into a randomized trial, comparing the effect of midthoracic (T) and lumbar (L) epidural morphine on postoperative pain and pulmonary function. Five mg morphine was injected through the catheter at the end of the operation, and subsequently three times a day. Six, 30 and 54 h postoperatively, the following tests were performed: linear analogue pain score, arterial gas tensions (PaO 2 , PaCO 2 and pH), forced ventilatory capacity (FVC), forced expiratory volume in 1 s (FEV 1 ) and peak expiratory flow rate (PEF). The changes in pain score (increase of the median): T: 21, 6, 5, and L: 24, 15, 8 per cent of full scale), PaO 2 (decrease of the tension: T: 1.7, 2.1, 2.4, and L: 2.0, 2.8, 2.0 kPa), PaCO 2 , pH, FVC (decrease of the volume: T: 1.3, 1.1, 0.9, and L: 1.3, 1.3, 1.2 1). FEV 1 and PEF from the preoperative tests were not significantly different. It is concluded that the clinical effect of epidural morphine for postoperative pain treatment is the same or little different whether the administration takes place at the thoracic or lumbar level.