The Efficacy of Epidural Ropivacaine Plus Morphine as Post- Operative Analgesia in Major Lumbar Spine Surgery: A Randomized Prospective Double-Blind Study

Background: Post-operative pain control includes oral or intravenous analgesics with different combination. However due to its side effects many adjuvants in pain control were studied. Epidural anesthesia and analgesia have been superior to intravenous analgesia with respect to pain quality and incidence of side effects. This study is a modification on previous studies by placing the analgesic as bolus with direct visualization and not using an epidural catheter. Pain control was then observed post operatively after weaning form general anesthesia using Ropivacaine plus normal saline as the control and compared to its efficacy of analgesic control with Ropivacaineplus Morphine as the experimental group.

Methods: This is a randomized prospective double-blind study.

Results: With a total of 18 patients (9 control and 9 experimental) there was noted to have significant difference between the 2 groups. The experimental group that received ropivacaine + morphine has a better pain control post op as there is decrease rescue medication given and it was noted to be at 18th hour post op. In comparison with the control group (Ropivacaine + normal saline), all 9 patients received the rescue medication with a mean post op time of 2 hours and some have 2 rescue medications in 24 hours.

Conclusion: Epidural route using Ropivacaine and morphine as a bolus with no epidural catheter is a safe alternative. It shows good pain control and efficacy with no reported adverse effects.

Keywords: Epidural Anesthesia, Post-operative Analgesia, Lumbar Spine Surgery, Ropivacaine and Morphine