The Effect of Epidural Lidocaine Infused with Morphine on Pain and Bowel Motility after Hysterectomy.
10.4097/kjae.2000.39.1.45
- Author:
Young Kyun CHOE
1
;
Seong Min OH
;
Jeong Hun KIM
;
Soon Ho CHEONG
;
Young Jae KIM
;
Jin Woo PARK
;
Chee Mahn SHIN
;
Hyo Seong PARK
;
Ju Yuel PARK
Author Information
1. Department of Anesthesiology, College of Medicine, Inje University, Paik Hospital, Pusan, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Analgesia: epidural;
postoperative;
Gastrointestinal tract: motility;
postoperative;
Pharmacology: lidocaine;
morphine
- MeSH:
Abdominal Cavity;
Anesthesia, Epidural;
Female;
Flatulence;
Humans;
Hysterectomy*;
Ileus;
Infusion Pumps;
Lidocaine*;
Morphine*;
Pain, Postoperative;
Peritoneum;
Reflex
- From:Korean Journal of Anesthesiology
2000;39(1):45-50
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Postoperative ileus is considered to be caused by the activation of spinal reflexes originating from the abdominal cavity with the sympathetic nerves as the efferent nerves. Epidural anesthesia as a perioperative adjunct has been shown to provide superior pain control, and has been implicated in more rapid postoperative ileus resolution possibly through a sympathetic block mechanism. This study was undertaken to compare the effects of epidural morphine-lidocaine with those of epidural morphine alone on postoperative bowel motility and pain. METHODS: Forty-four ASA I or II women scheduled for transabdominal hysterectomy were considered for the study. They were randomly allocated to one of two groups. Group M (n = 22) received postoperative epidural morphine 16 mg by infusion pump, 2 ml/h, for 2 days, group ML (n = 22) received morphine 16 mg plus 0.42% lidocaine by infusion pump, 2 ml/h, for 2 days. Both group received morphine 4 mg in 0.5% lidocaine 8 ml epidurally as a single bolus when the peritoneum was closed. Postoperative pain, and the time interval from termination of operation to the first passage of flatus were checked RESULTS: In group ML, the times for first passing of flatus (33.4 +/- 10.5 h; mean +/- SD) and visual analogue scale score (0.3 +/- 0.6) were significantly shorter and lower than in group M (flatus 42.6 +/- 8.4 h and VAS score 1.3 +/- 1.7). CONCLUSIONS: The epidural lidocaine infused with morphine demonstrated earlier recovery of bowel motility and better postoperative pain relief than the epidural morphine alone.
