EPIDURAL MORPHINE PLUS BUPIVACAINE FOR RELIEF OF POSTOPERATIVE PAIN FOLLOWING HARRINGTON ROD INSERTION FOR CORRECTION OF IDIOPATHIC SCOLIOSIS

The aim of this study was to assess the efficacy of epidural morphine plus bupivacaine for post-operative pain control following Harrington rod insertion. In 22 scoliotic patients, studied prospectively, the ep idural catheter was positioned under direct vision, intra-operatively before wound closure. Post-operatively, the patients received 2 mg mor phine in 4 mi of 0.25% bupivacaine through the epidural catheter whene ver they complained of pain. The pain score was assessed before and af ter every injection, using the Visual Analogue Pain Scale, and side-ef fects were monitored. All patients had adequate pain relief following analgesic administration. The mean (+/- SD) pre-injection pain score d ecreased from 2.5 +/- 0.15 on the first past-operative day to 0.7 +/- 0.2 by the fourth day. The side-effects, including nausea, vomiting an d pruritus, were minimal. It is concluded that morphine, in 0.25% bupi vacaine administered through an intra-operatively placed epidural cath eter, provides a safe and effective post-operative analgesia in patien ts undergoing Harrington rod insertion for idiopathic scoliosis.