[Epidural morphine as a sedative after open heart surgery: in cases of coronary artery bypass graft]

Abstract

20 cases of coronary artery bypass graft (CABG) were divided randomly into 2 groups. 10 cases (Group I) received epidural catheterization between Th 6/7 at least 24 hours prior to the operation. After operation, these 10 cases were sedated with 3 mg of Morphine hydrochloride given through the epidural catheter. Other 10 cases (Group II) were sedated with 10 mg of Morphine given intravenously. Parameters of cardiorespiratory dynamics such as arterial blood pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, central venous pressure, oxygen saturation of mixed venous blood, cardiac index, doses of intravenous Nitroglycerin, Dopamine and Dobutamine, arterial blood gas analysis were measured and compared in two groups. No side effect caused by the epidural catheter was found in Group I. Parameters with significant difference in two groups were only doses of Dopamine and base excess from blood gas analysis, but these were not due to the method of sedation. Frequency of the sedation needed within 24 hours after operation was fewer, and the condition of the sedation was better in Group I. The course of postoperative management had no difference between both groups. Epidural Morphine was concluded to be an employable method of sedation after CABG.