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Reg Anesth. 1993 Nov-Dec;18(6):351-5.

Thoracic versus lumbar administration of epidural morphine for postoperative analgesia after thoracotomy.

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1
Department of Anesthesiology, New York University Medical Center, NY 10016.

Abstract

BACKGROUND AND OBJECTIVES:

The purpose of this study was to compare the effects of thoracic and lumbar epidural morphine on pulmonary function and analgesia after thoracotomy for pulmonary resection.

METHODS:

Twenty-seven patients were randomized into two groups to receive either thoracic or lumbar epidural morphine as needed for postoperative analgesia. Postoperative pain was assessed hourly on a 10-cm visual analog scale (VAS), and epidural morphine was administered in 3 mg doses for a VAS score > 2 cm. Patients underwent pulmonary function tests (forced vital capacity, forced expiratory volume at 1 second, peak expiratory flow) preoperatively, and 24 hours postoperatively. Results were expressed as mean +/- 1 SE and analyzed using Student's t-test and Student-Newman-Keuls test at p < 0.05.

RESULTS:

Twenty patients completed the study (n = 10 per group). Patients in the thoracic group required 3.1 +/- 0.4 injections to a total morphine dose of 11.9 +/- 1.4 mg during the first 24 hours postoperatively, and those in the lumbar group required 4.7 +/- 0.4 doses to a total 24-hour morphine dose of 16.4 +/- 1.2 mg (p < 0.05). Median hourly VAS scores were similar in both groups. Postoperative pulmonary function decreased in both groups without intergroup differences.

CONCLUSIONS:

The authors conclude that thoracic epidural morphine administration in patients after thoracotomy results in decreased morphine requirements and the same degree of analgesia as does lumbar administration.

PMID:
8117630
[Indexed for MEDLINE]
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