Epidural Morphine plus Bupivacaine for Relief of Postoperative Pain following Harrington Rod Insertion for Correction of Idiopathic Scoliosis

Abstract

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 epidural catheter was positioned under direct vision, intra-operatively before wound closure. Post-operatively, the patients received 2 mg morphine in 4 ml of 0.25% bupivacaine through the epidural catheter whenever they complained of pain. The pain score was assessed before and after every injection, using the Visual Analogue Pain Scale, and side-effects were monitored. All patients had adequate pain relief following analgesic administration. The mean (± SD) pre-injection pain score decreased from 2.5 ± 0.15 on the first post-operative day to 0.7 ± 0.2 by the fourth day. The side-effects, including nausea, vomiting and pruritus, were minimal. It is concluded that morphine, in 0.25% bupivacaine administered through an intra-operatively placed epidural catheter, provides a safe and effective post-operative analgesia in patients undergoing Harrington rod insertion for idiopathic scoliosis.