Routine use of epidural morphine in patients following lumbar spine surgery

In order to evaluate the effectiveness of epidural morphine for postoperative pain in management, 45 patients who received epidural morphine after lumbar spine surgery (Group A) were compared to 22 patients who received traditional analgesia after lumbar spine surgery (Group B). Group A used significantly fewer parenteral and oral analgesics than did Group B during the first 24 h after surgery and during the time the epidural morphine was administered (1-3 days postoperatively). Although no patients in Group A had respiratory depression, about half experienced minor side effects from epidural morphine. Analysis of the possible relationship of the catheter tip position to the analgesic effect was also done in 20 of these patients. There was no relationship of the level of the catheter tip (T10 to L5) to the narcotic equivalents of supplemental narcotics used postoperatively. Thus, epidural morphine was an easy, safe, and effective means of increasing patient comfort and reducing analgesic requirements in the first few days after spinal surgery.