Epidural morphine plus bupivacaine for relief of post-operative pain following Harrington rod insertion for correction of idiopathic scoliosis.

The aim of this study was to assess the efficacy of epidural morphine plus bupivacaine for post-operative pain control following Harrington rod insertion. In 22 scoliotic patients, studied prospectively, the epidural catheter was positioned under direct vision, intra-operatively before wound closure. Post-operatively, the patients received 2 mg morphine in 4 ml of 0.25% bupivacaine through the epidural catheter whenever they complained of pain. The pain score was assessed before and after every injection, using the Visual Analogue Pain Scale, and side-effects were monitored. All patients had adequate pain relief following analgesic administration. The mean (+/- SD) pre-injection pain score decreased from 2.5 +/- 0.15 on the first post-operative day to 0.7 +/- 0.2 by the fourth day. The side-effects, including nausea, vomiting and pruritus, were minimal. It is concluded that morphine, in 0.25% bupivacaine administered through an intra-operatively placed epidural catheter, provides a safe and effective post-operative analgesia in patients undergoing Harrington rod insertion for idiopathic scoliosis.