COMPARISON OF INTRAVENOUS AND EPIDURAL PATIENT CONTROLLED MORPHINE ANALGESIA AFTER BREAST CARCINOMA RADICAL OPERATION

Objective: Comparing the efficacy and side effects of intravenous patient controlled morphine analgesia(PCIA) with epidural patient controlled morphine analgesia(PCEA). Methods: 40 ASA Ⅰ～Ⅱ class patients after breast cancinoma radical operation were randomly divided into two equal groups. PCIA group received loading dose of saline 4ml containing morphine 2mg, then infusion of saline 1.5ml containing morphine 0.45mg/h plus PCIA of 4ml containing morphine 1.2mg; PCEA group received loading dose as PCIA, then infusion of saline 1.5ml containing morphine 0.225mg/h plus PCEA of 4ml containing morphine 0.6mg. Lockout time was 5～10 min. The analgesia was maintained for 48h. VAS pain scores, patient satisfaction, sedation scores, morphine dose, side effects and intestinal function recovery were observed and recorded. Results: VAS pain scores were lower in PCEA group than in PCIA group(P0.05). Patient satisfaction had a similar score(P0.05). Sedation scores were higher in the PCIA group than in PCEA group 12h after operation(P0.01). PCEA group used significantly less morphine(P0.01). Incidence of urinary retention was higher in PCEA group than in PCIA group(P0.01). There were no differences in intestinal function recovery (P0.05). Conclusion: Both PCIA and PCEA have their own advantages and shortcomings, remain clinically acceptable.