Combined Epidural Morphine and Midazolam on Postoperative Pain

Effect of Epidural Morphine and Midazolam on Postoperative Painin Patients Undergoing Major Abdominal Cancer Surgery

this study aim to Compare the effect of preoperative Epidural Midazolam, Morphine and their combination in postoperative pain relief and total morphine consumption.

Major abdominal surgeries with abdominal incisions lead to severe abdominal pain, which if treated inadequately, can cause shallow breathing, atelectasis, retention of secretions and lack of cooperation in physiotherapy. This increases the incidence of post-operative morbidity and leads to delayed recovery.Epidural anesthesia is safe and inexpensive technique with the advantage of providing surgical anesthesia and prolonged postoperative pain relief. It also an effective treatment of operative pain blunts autonomic, somatic and endocrine responses. Morphine and midazolam can be used as adjuvant to bupivicain to reduced the postoperative pain

epidural needle in the L1-2 or L2-3 space , and using loss of resistance technique udder strict aseptic condition 10 ml of the prepared drug will be given

the time between the end of operation and tracheal extubation to the first request for supplemental analgesics and its administration to the patient

Inclusion Criteria: ASA I-II patients scheduled for major abdominal cancer surgeries Exclusion Criteria: patients with known allergy to the study drugs, significant cardiac, respiratory, renal or hepatic disease, drug or alcohol abuse, psychiatric illness that would interfere with perception and assessment of pain.