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2006, Number 4

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Rev Mex Anest 2006; 29 (4)

Epidural morphine and clonidine in patients with cancer of prostate for the postoperative pain

de la Paz-Estrada C

Language: Spanish
References: 24
Page: 226-230
PDF size: 88.32 Kb.


ABSTRACT

Objective: To assess the postoperative analgesic effect of epidural morphine compared to epidural clonidine in patients with prostate cancer undergoing elective surgery. Materials and methods: A prospective study was carried out in 48 randomly selected patients admitted to the “Guillermo Luis Fernández Hernández-Baquero” Hospital, Moa, Holguín, Cuba, from September 2003 through January 2004, undergoing elective surgery for prostate cancer. Ages ranged from 65 to 76 years old. Patients were classified as ASA II, according to the American Society of Anesthesiologists. Blood pressure, electrocardiogram, and pulse oximetry were continuously monitored. Patients were given 40 m/kg IM midazolam in the immediate preoperative period. Epidural lumbar anesthesia was applied as follows: Group I (n = 24) was given 7 mg/kg 2% lidocaine with epinephrine plus 2 mg morphine sulfate; Group II (n = 24) was also given 7 mg/kg 2% lidocaine with epinephrine, but received 2.5 m/kg clonidine instead. Blood pressure and heart rate were monitored, and the duration of analgesia was assessed on the same visual scale in both groups. A descriptive statistical analysis was performed with the c2 and Student’s t-test to evaluate statistical significance. Results: The duration of analgesia was longer in Group I, with 1019.2 ± 1.6 minutes (p ‹ 0.05). Adverse events in Group I were emesis in 17.4% and pruritus in 13%, whereas in Group II, adverse events were bradycardia in 21.6%, sedation in 19.3%, and hypotension in 11.6%. Conclusions: Duration of analgesia with morphine is significantly longer compared to clonidine, with minimal side effects.


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