Continuous epidural morphine and lidocaine for postoperative pain control in obstetric and gynecologic operation

Postoperative wound pain is a remarkable distress and may precipitate major complication. We attempted to develop a reliable and effective technique for postoperative analgesia that is safe and simple enough to be provided in an ordinary ward of a rural hospital.

A retrospective study of continuous epidural infusion of morphine 7.5 mg in 60 mL diluted lidocaine for postoperative pain control in 156 patients in the past year was undertaken. Among the patients, one hundred and twelve patients had undergone. Cesarean Section, and 44 patients had uterine or adnexal operations. All patients received epidural anesthesia.

Effective analgesia was achieved in all cases throughout the postoperative period. Pain relief was long lasting and there were only 5 patients (3.2%) who required some additional narcotics. The mean interval between completion of the operation and passage of flatus was 33.2 h. Only 48 patients (30.8%) complained of skin itching, 39 patients (25.0%) reported nausea and vomiting and 62 cases (39.7%) experienced constipation. Urinary retention after Foley catheter removal was noted in 9 cases (5.8%). No major complication pertaining to the technique was encountered.

We concluded that continuous epidural infusion of morphine and diluted lidocaine is an effective, simple and safe technique for postoperative pain control in obstetric and gynecologic operation and it can be administered routinely even in a rural hospital.