Epidural or intrathecal morphine for post-operative analgesia following laparoscopic endometriosis surgery

Abstract

Background: Endometriosis is the development of endometrial glands or stroma outside the uterine cavity, in the pelvis, ovaries, and fallopian tubes. Laproscopy is the most common method used in management of endometriosis and it also eliminates endometriosis-related scar tissue, implants, and cysts. Epidural or intrathecal morphine is an effective way to alleviate post-operative pain after laparoscopic endometriosis surgery.Methods: Literature search was conducted in three electronic databases-Google Scholar, Cochrane (Controlled Trials Register), and PubMed (MEDLINE/Index Medicus). Postoperative pain, epidural and intrathecal morphine, laparoscopy surgery, patient-controlled analgesia (PCA), opioids, and morphine were the search criteria used.Results: After removing duplicate studies, the search yielded 106 results. Out of which50 full-text publications that matched the inclusion criterion were retrieved.Conclusion: Single intrathecal morphine injection is safe and effective in managing post-operative pain, however continuous epidural analgesia is risky and difficult to manage after laparoscopic endometriosis surgery.