Value of lyophilized morphine in myocardial revascularization

Abstract

Introduction: epidural analgesia is a mainstay in cardiac surgery. Objectives: The aim of this study was to compare the use of lyophilized morphine and epidural bupivacaine in postoperative analgesia of myocardial revascularization. Method: A comparative and prospective study was conducted in 160 patients. They were divided into two groups: group M received epidural analgesia with morphine (2 mg) associated with 100 mg of bupivacaine, and group B bupivacaine only. Results: there was a prevalence of males. The ages and the average weights of both groups were similar (p>0.05). In group M, 90% of patients had excellent analgesia eight hours after the intervention, and it was good to excellent after 12 and 24 hours. On the other hand, 50% of patients in group B talked of an average analgesia eight hours after the operation –which extended to 80% of patients after 12 hours– and, after 24 hours, all the patients in group B complained of an inadequate or poor analgesia (p<0.05). The average postoperative analgesia obtained in group M was 29.41 hours, and 9.76 hours in group B (p<0.01). The main adverse events were hypotension and bradycardia. Conclusions: Morphine showed its usefulness as an analgesic agent in the surgical operation of the coronary arteries. Patients with epidural bupivacaine and morphine had a better analgesia with longer duration than those treated with bupivacaine only.

Keywords

• revascularización miocárdica
• morfina/administración & dosificación
• evaluación de eficacia-efectividad de intervenciones