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    Comparison of morphine usage in intravenous PCA and epidural PCA
    (2003) To?al T.; Şahin Ş.; Durmuş M.; Türköz A.; Köro?lu A.; Ayas A.; Ersoy M.Ö.
    The aim of this study is to compare morphine for postoperative pain management by using intravenous and epidural patient controlled analgesia (PCA), for analgesic efficacy and side effects. After ethical committee approval was obtained, thirty cases aged 30-65 years (ASA I-II) were divided randomly into two groups. Group I received epidural PCA as loading dose morphine 2 mg, basal infusion rate 0.2 mg/h, bolus dose 0.5 mg and lockout time 30 minutes. Group II received intravenous PCA as loading dose morphine 5 mg, basal infusion rate 0.3 mg/h, bolus dose 1 mg and lockout time 15 minutes. Standard general anaesthesia procedure was performed. Procedure was started just after the operation. The mean arterial pressure, heart rate, respiratory rate, Visual Analogue Scale (VAS) and sedation scores were recorded at the end of the operation and at 1st, 2nd, 4th, 8th, 12th, 16th, 20th, 24th hour after the operation. Total morphine consumption, the number of request, the bolus dose delivery rate and side effects were recorded at the end of postoperative 24th hour. During 24 hours, morphine consumption and bolus dose delivery rate was significantly lower in Group I and the number of the request was significantly lower in Group II. There was no statistical difference between the two groups in terms of efficacy and VAS during 24 hours, except for the 8th hour. The VAS rates were below 3, after 8th hour in groups. VAS 8 score was lower in Group I. VAS rates at the hours 1, 2, 4, 8, 12, 16, 20, 24 decreased significantly compared to the rates at the beginning in each of the groups. Sedation scores at 1st, 2nd, 4th and 8th hour in Group I was lower than Group II. Pruritis was higher in Group I. There was no significant statistical difference between the two groups in terms of heart rate, mean arterial pressure and respiratory rate. As a result we conclude that the usage of morphine for the postoperative pain management by epidural or intravenous PCA provide effective analgesia only by short lock-out time and appropriate loading and bolus close.