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The effect of IVPCA morphine on post-hysterectomy bowel function
Kuang-Cheng Chan1, Ya-Jung Cheng, Guang-Ta Huang
1Department of Anesthesiology, National Taiwan University, College of Medicine and Hospital, Taipei, Taiwan, R.O.C.
Acta Anaesthesiologica Sinica
|August 27, 2002
Summary
Intravenous patient-controlled analgesia (IVPCA) morphine did not correlate with delayed first flatus passage in women after hysterectomy. This suggests IVPCA may mitigate morphine-induced post-operative bowel dysfunction.
Area of Science:
- Anesthesiology
- Gastroenterology
- Pharmacology
Background:
- Morphine can cause dose-dependent bowel dysfunction, typically studied with single injections.
- Intravenous patient-controlled analgesia (IVPCA) offers divided doses on demand, mimicking continuous infusion benefits.
- The effect of IVPCA morphine on post-operative bowel function remains uninvestigated.
Purpose of the Study:
- To investigate the association between morphine consumption via IVPCA and the time to first flatus passage post-abdominal total hysterectomy (ATH).
Main Methods:
- Fifty-one women undergoing ATH for uterine myoma were enrolled.
- Morphine was administered intravenously via IVPCA immediately after general anesthesia.
- Correlation between morphine dose and time of first flatus passage was analyzed.
Main Results:
- 96% of patients experienced mild pain with IVPCA morphine.
- Average morphine consumption was 16.9 mg by the time of first flatus passage.
- No significant correlation was found between morphine dose and time to first flatus passage (r = 0.053, P > 0.05).
Conclusions:
- IVPCA morphine did not suppress bowel function in this cohort.
- The pharmacokinetic profile of IVPCA may reduce morphine-induced bowel dysfunction at therapeutic levels.
- IVPCA is a viable option for post-operative pain control with potentially fewer gastrointestinal side effects.