Epidural injection of morphine and ketamine for postoperative analgesia

Objective To study the analgesic effects and side effects of epidural injection of morphine and ketamine for postoperative pain-relief.Methods Ninety ASA I-II patients were randomly divided into three groups.Intrathecal group(group A,30 patients) received a spinal injection of bupivacaine with morphine 0.25mg.Epidural morphine group(group B,30 patients) received a spinal injection of bupivacaine and epidural morphine 2mg.Epidural morphine and ketamine group(group C,30 patients) received a spinal injection of bupivacaine and epidural morphine 2mg and ketamine 1.2mg/kg.The visual analogue scale(VAS) was assessed at 0-4,5-8,9-20,21-24,25-48h after operation,Ramsay sedation scores and Bruggrmann comfort scale(BCS) were done either at the same time points in three groups.The incidence of side effects was recorded.Results The VAS was significantly less in group A and C than those in group B(P0.01 or P0.05).Ramsay sedation scores and BCS were significantly higher in group A and C compared with those in group B(P0.01 or P0.05).The side effects was significantly increased in group A compared with those in group B and C.But there was no significant difference of the postperative visual analogue scale(VAS),Ramsay sedation scores and Bruggrrmann comfort scale(BCS) between the group A and group C(P0.05).Conclusion Epidural injection of morphine and ketamine for postoperative analgesia is not only better than epidural morphine but also has less side effects than intrathecal morphine.