CONTINUOUS-INFUSION OF EPIDURAL MORPHINE IN FROSTBITE

After frostbite injury, the phases of rewarming and progressive injury may cause intense pain for the patient. Although parenteral narcotic agents are the usual method of pain relief, they have well-described a dverse effects such as heavy sedation, respiratory depression, and nau sea and vomiting. In frostbite injury of the lower extremities, epidur al blockade has the potential to provide good pain relief with fewer o f those complications. However, the associated sympathetic blockade is believed by many clinicians to be of no benefit and by some to be pot entially harmful. Epidural narcotics have the selective advantage of p roviding analgesia without sympathetic blockade. In this case report, the use of continuous epidural morphine during the first 24 hours afte r severe bilateral frostbite injury to the feet is described. The tech nique provided effective pain control, and no complications occurred. To our knowledge, use of continuous epidural morphine after frostbite injury has not been reported previously, further use of this technique will be required to clarify its efficacy.