Caudal Morphine for Postoperative Pain Control after Abdominal Surgery

천골강내로 주입한 Morphine에 의한 상.하복부 수술후 진통효과

Caudal narcotic analgesia was assesses after the injection of 3mg morphine diluted in 30ml (physiologic) saline into the sacral canal in 15 Patients after upper abdominal surgery, in 20 patients after lower abdominal surgery under general anesthesia, and in 20 patients after perianal surgery under caudal block. Pain relief was evaluated by the subsequent need for systemic analgesics. All eases had considerable relief from pain an4 the morphine was effective for 12 or more hours. There were no significant differances between pain relief of the upper abdominal and lower abdominal surgery group, upper abdominal and perianal surgery group, and lower abdominal and perianal surgery group (p>0.05, p>0.05, p>0.05). It is suggested that the morphine, which was administered into the sacral, cannal, reached the subarachnoid space and produced it's effect by direct action on the specific opiate receptors in the substantia gelatinosa of th.8 posterior horn cell of the spinal cord. Consequently, whether analgesia from epidural narcotics appears to be segmental in distribution or not is still in controversy.