Pain Team
Pain Team
Department of Anaesthesia and Intensive Care
Prince of Wales Hospital
Protocol of Epidural Morphine Infusion
Epidural morphine infusion is recommended as an alternative to conventional epidural mixture of local anaesthetic (bupivacaine or ropivacaine) and fentanyl in acute postoperative analgesia in surgical wards if conventional epidural local anaesthetic and fentanyl infusion fails to provide adequate analgesia and either one of the following criteria is met:
1. Conventional epidural local anaesthetic and fentanyl infusion fails to provide adequate analgesia because of incomplete segment of neural blockade in relation to surgical wound.
2. Conventional epidural local anaesthetic and fentanyl infusion causes significant motor or sympathetic blockade and side effect, e.g. hypotension.
Steps of Setting up Epidural Morphine:
1. Stop conventional epidural local anaesthetic and fentanyl infusion.
2. No parenteral opioid or other CNS depressant to be given except as ordered by APS.
3. Maintain iv access for 24 hr after last dose of epidural morphine.
4. Give morphine bolus 2mg (for age>=80 yrs) or 3mg (for age ................
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