Comparison of Epidurally Administered Sufentanil, Morphine, and Sufentanil‐Morphine Combination for Postoperative Analgesia

Postoperative analgesia provided by epidurally administered sufentanil and/or morphine was evaluated in 45 patients recovering from major gynecologic surgery. At the first complaint of pain in the Postanesthesia Care Unit, patients received a single epidural bolus of 30 μg sufentanil (group A), 5 mg morphine (group B), or 30 μg sufentanil plus 3 mg morphine (group C) in a randomized blinded fashion. Analgesic efficacy was assessed throughout the 24-h study period with 10-cm visual analog scales. The need for additional postoperative analgesia (patient‐controlled analgesia, 1 mg of morphine every 6 min as necessary) and the incidence of adverse effects were also assessed.Patients receiving sufentanil (groups A and C) had significantly faster onset of analgesia than did patients given morphine alone (group B, P<0.05). Group B subjects experienced the longest duration of analgesia (B us A and C, P<0.05) and required significantly less patient‐controlled analgesia (morphine) than patients in group A (P<0.05). No patient developed clinically significant respiratory depression or excessive sedation, and there were no intergroup differences in incidence of pruritus or nausea (P value not significant). The data indicate that a mixture of sufentanil and morphine provides either a more rapid onset of epidural analgesia or reduced patient‐controlled analgesia narcotic requirement than respective doses of each agent administered alone.