Use of single-dose epidural morphine in a patient undergoing an abdominal aortic aneurysm resection

To avoid possible trauma to the epidural venous plexus in a 56-year-old male who presented for abdominal aortic aneurysm resection, the authors preoperatively injected a single dose of epidural morphine rather than inserting an indwelling epidural catheter. The patient's intraoperative anesthetic requirements appeared to have been decreased, he was extubated shortly after the end of the procedure, and he experienced good postoperative analgesia. No untoward neurologic sequelae occurred. The authors feel that a single dose of epidural morphine, compared to epidural catheter placement when systemic heparinization is planned, decreases intraoperative anesthetic requirements, provides good postoperative analgesia, and may have the benefit of decreasing the possibility of epidural hematoma formation.