Epidural opiate and perioperative analgesia

Epidural injections of 5 mg nicomorphine in 20 ml 5% glucose wee given to 10 gynaecological patients to provide intra-operative and post-operative analgesia. Signs of changed nociception appeared within 5 min. The maximum change occurred within 20 min. Effectiveness was at least 3 1/2 h. After an observation period of 30 min, light general anaesthesia is supplemented to give excellent operating conditions. It is suggested that opiates produce these effects by a direct action on the endorphin "pain" modulatory system of human beings at spinal level.