Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Pain Control with Continuous Infusion of Epidural Morphine and Bupivacaine after Lumbar Spinal Surgery : A Prospective Study

요추부 수술후 경막외 Morphine Sulfate와 Bupivacaine의 지속적 주입에 의한 통증 조절의 효과

  • Shin, Moon Soo (Department of Neurosurgery, College of Medicine, Pochon CHA University, Bundang CHA Hospital) ;
  • Lee, Byung Hee (Department of Anesthesiology, College of Medicine, Pochon CHA University, Bundang CHA Hospital) ;
  • Choi, Hun Kyu (Department of Neurosurgery, College of Medicine, Pochon CHA University, Bundang CHA Hospital) ;
  • Noh, Jae Sub (Department of Neurosurgery, College of Medicine, Pochon CHA University, Bundang CHA Hospital) ;
  • Ahn, Jung Young (Department of Neurosurgery, College of Medicine, Pochon CHA University, Bundang CHA Hospital) ;
  • Sheen, Seung Hun (Department of Neurosurgery, College of Medicine, Pochon CHA University, Bundang CHA Hospital) ;
  • Lee, Byung Hee (Department of Radiology, College of Medicine, Pochon CHA University, Bundang CHA Hospital) ;
  • Chung, Bong Sub (Department of Neurosurgery, College of Medicine, Pochon CHA University, Bundang CHA Hospital)
  • 신문수 (포천중문 의과대학 분당차병원 신경외과학교실) ;
  • 이병희 (포천중문 의과대학 분당차병원 방사선과학교실) ;
  • 최훈규 (포천중문 의과대학 분당차병원 신경외과학교실) ;
  • 노재섭 (포천중문 의과대학 분당차병원 신경외과학교실) ;
  • 안정용 (포천중문 의과대학 분당차병원 신경외과학교실) ;
  • 신승훈 (포천중문 의과대학 분당차병원 신경외과학교실) ;
  • 이병희 (포천중문 의과대학 분당차병원 마취과학교실) ;
  • 정봉섭 (포천중문 의과대학 분당차병원 신경외과학교실)
  • Received : 1999.04.26
  • Accepted : 1999.12.29
  • Published : 2000.05.28
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Abstract

Objective : The purpose of this non randomized prospective study was to verify the effect of pain control in small doses of epidural morphine and bupivacaine through continuous infusion for 48 hours. Patients and Methods : Thirty-five patients who underwent spine surgery including laminectomy, fusion with fixation were assigned into two groups ; pain control group(n＝20) and control group(n＝15). Pain score was measured on a visual analogue scale(VAS). A continuous infusor was used to give morphine and bupivacaine continuously via indwelling epidural catheter which was placed before closure of muscles in pain control group. Results : Mean scores(VAS) of pain control group were between 1.3 and 2.1 from the 30 min to the 72 hour, but the lowest mean score in the control group was about 2.6 at the 72 hour. Although a number of extra-analgesics were used in control group, differences of mean scores were statistically significant till 24 hour in pain control group. The patients in pain control group was less painful than the patients in control group from 24 hour till 72 hour, but it was statistically insignificant. There were some side effects such as nausea/vomiting, pruritus, urinary retention which existed transiently, but there was no respiratory depression. Conclusion : It was concluded that the early postoperative pain can be easily and safely controlled with continuous infusion of epidural morphine and bupivacaine in small doses.

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