Epidural morphine for control of pain after spinal surgery: a preliminary report

Epidural opiates have been used successfully for the control of postoperative pain after obstetrical, abdominal, and orthopedic procedures. The use of these agents for the control of pain after operation on the thoracic and lumbar spine is reported. A catheter is inserted under direct vision into the epidural space after semihemilaminectomy and disc excision, posterior decompressive lumbar laminectomy, and anterolateral thoracolumbar decompression and just before wound closure. Excellent postoperative pain relief is achieved for 8 to 20 hours after single epidural injections of between 2 and 6 mg of morphine. Catheters are left in situ for 2 to 5 days. To date, no complications requiring treatment have been encountered with this approach.