Epidural Morphine by the Caudal Route for Postoperative Pain Relief

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Abstract
In order to detect the ability of epidural morphine, administered by the caudal route, to produce pain relief and in order to compare pain relief by this method with i.m. injections of opiates, 90 patients scheduled for surgery below the umbilical level were studied. Preservative-free morphine 4 mg in 10 ml normal saline was compared with i.m. injections of opiates, using a visual analog scale. The average pain score was significantly lower in the epidural group during the first 12 postoperative hours. In the epidural group, 38% required additional i.m. injections during the first 12 postoperative hours, whereas 86% of the patients in the i.m. group received opiate injections. No patients developed respiratory depression. Side effects were more common in the i.m. group than in the epidural group. Epidural morphine by the caudal route is evidently a better choice than i.m. injections in controlling postoperative pain below the umbilical level.