The effect of epidural morphine on ureteral colic and spasm of the bladder

Twenty-one patients suffering from severe pain associated with ureteric stones and spasm of the bladder which did not respond to repeated systemic injections of pethidine and papaverine received continuous epidural morphine. The morphine, 3-4 mg per dose, was injected into the lumbar-epidural space, and 15-20 min later all patients were pain free for at least 24 h. Administration of morphine was continued for periods ranging from 2 days to 2 weeks according to need. Eleven of the patients with ureterolithiasis passed the stone spontaneously. Epidural morphine analgesia is indicated for persistent ureteral colic and for spasm of the bladder when conventional treatment fails or systemic drugs are contraindicated. It abolishes pain and spasm for prolonged periods of time and does not interfere with the spontaneous elimination of stone.