COMPARISON BETWEEN EPIDURAL MORPHINE VERSUS MORPHINE + FENTANYL IN LUNG RESECTION SURGERY

Background – Use of narcotics in the epidural space has dramatically changed patient care after surgery because it provides suitable analgesia with fewer complications than other methods. Morphine is a narcotic widely used in the epidural space for pain management, but its use is associated with several complications such as urinary retention, nausea, and vomiting. This study was designed to determine whether the addition of fentanyl to epidural morphine would reduce the associated complications. Methods – Of patients prepared for lung surgery, 72 were selected for epidural analgesia. Twelve patients met the exclusion criteria, but the remaining patients were randomized in a double-blind manner to receive morphine plus fentanyl (n = 30) or morphine alone (control group; n = 30). Drugs were injected when requested by patients , when the visual and verbal pain scores reached 2. Vital signs were checked and complications were recorded in a predefined questionnaire. Results – At the end of the study, there was a higher prevalence of complications in the morphine group than in the morphine plus fentanyl group (p < 0.05). There was no significant difference in analgesic time between the two groups, and analgesic time was more than expected in the morphine plus fentanyl group (p < 0.000). Conclusion – The results of this study showed that adding fentanyl to morphine in epidural analgesia can reduce the complications with at least equal analgesic time. Thus, we can consider this combination as a good choice for epidural analgesia in thoracotomy patients.