Turkish Neurosurgery 1999 , Vol 9 , Num 1-2
Ahmet COŞAR2, Mehmet DANEYEMEZ1, Ercan KURT2, Ferruh BİLGİN2, Zafer ÇANAKÇI1, Ferruh GEZEN1, A. Hikmet SÜER2
1Department of Neurosurgery, Gülhane Military Medical Academy, Medical Faculty, Ankara, Turkey
2Department of Anesthesiology and Reanimation, Gülhane Military Medical Academy, Medical Faculty, Ankara, Turkey
A comparison of the effects of epidural morphine and epidural morphine + bupivacaine on postoperative pain following lumbar laminectomy and discectomy. Thirty American Society of Anesthesiolgists (ASA) I patients undergoing lumbar laminectomy and discectomy were randomly assigned to two groups (n = l5/group). In each case, after removing the herniated disc, the surgeon placed an epidural catheter. Then, while in the recovery room, patients were asked to assess their pain according to a 10 cm Visual Analogue Scale (VAS). Following this, group I received an epidural injection of 2-mg morphine + 10 ml normal saline, and group II received 2 mg morphine + 2 ml bupivacaine 0.5% + 8-ml normal saline by the same route. Postoperative analgesia was achieved in most patients, and alternative parenteral analgesic drugs were used in those who found the epidural treatment insufficient. Side effects were encountered in three group I patients, the problems being globe vesicale, wound infection, and difficult micturition. We achieved satisfactory postoperative analgesia with epidural morphine or epidural morphine + bupivacaine in 24 of 30 patients who underwent lumbar laminectomy and discectomy. Adding bupivacaine to morphine does not enhance the analgesic effect, and there were no significant difference in quality and duration of analgesia between the morphine and morphine + bupivacaine groups. Keywords : Bupivacaine, epidural, laminectomy, lumbar, morphine, postoperative analgesia
Corresponding author : Mehmet Daneyemez