Abstract

HERNANDEZ LUACES, Luis Felipe et al. Use of epidural morphine in the treatment of acute low back pain. Rev Cub Med Mil [online]. 2008, vol.37, n.1. ISSN 0138-6557.

A descriptive longitudinal and prospective study was conducted among the patients that received attention at the Pain Clinic of "Dr. Luis Díaz Soto" Higher Institute of Military Medicine from March 1st, 2003 to February 28th, 2005, with the diagnosis of acute low back pain, and that had a pain of intensive severity, quantified by the analogous visual scale of 8 or over. The proposal was to evaluate if the administration of morphine by epidural route modified the evolution of acute low back pain. Two groups were selected at random: a study group and a control group that received 3 ambulatory epidural analgesic blockings with local anaesthetic (bupivacaine) and steroids (triamcinolone acetate). The study group was also administered 2 mg of freeze-dried morphine. The evolution was evaluated, the degree and time of relief were registered, and they were related to sex and to the complications presented. Low back pain "without apparent cause" (69.14 %) was presented first, followed by that "related to effort" and, finally, "postraumatism". Nausea, urinary retention, hypotension and vomiting were the most common complications in the study group compared with the control group, although they did not have statistical significance. Pruritus was present in 6.25 % and arterial hypotension in 1.56 % that were only observed in the study group. It was concluded that adding freeze-dried morphine to the epidural blockage with bupivacaine and triamcinolone acetate for the treatment of acute low back pain, does not change the evolution of the pain in the first 30 hours.

Keywords : Low back pain; peridural blocking; epidural blocking; morphine; pain relief.

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