Pre- Versus Post-Incisional Epidural Morphine: Higher Postoperative Pain Perception and Extra Morphine Consumption
Status:
Completed
Trial end date:
2008-01-01
Target enrollment:
Participant gender:
Summary
Background and Objectives: Neuraxial administration of morphine is an effective way of
controlling postoperative pain and reducing analgesic consumption. Several animal models have
demonstrated that preemptive administration of neuraxial narcotics reduced pain while others
revealed the induction of post-incisional hypersensitivity. There have been no consistent
results in clinical setting either. This double blind, randomized study compared the effects
of PRE- vs. POST-incisional administration of neuraxial morphine on postoperative pain
perception and analgesic requirements over 48 hours following laparotomy for open colectomy
under standardized general anesthesia.
Methods: Twenty patients received epidural morphine (3 mg) pre-incision and saline after
wound closure (MO1 group), and 20 patients received epidural saline before incision and
morphine after wound closure (MO2 group). Postoperatively, all patients received boluses of
morphine (1.5 mg) via intravenous patient-controlled analgesia (IV-PCA), and rescue doses of
intramuscular diclofenac (75 mg) every 6 hours, as needed.