I had three injections all of which worked for a few days to two weeks then stopped. The excruciating pain returned and only Vicoden 5 mg 3-4 times a day controlled the pain. Vicoden at that dose is the lowest dose prescribed. it worked perfectly for several years and doctors refused to prescribed opioids for fear of losing their license. My sister recently died of throat cancer and she complained constantly of pain. She died with unrelieved pain. As a cancer patient she was prescribed Morphine 2 mg. every 6 hours. That is beyond ridiculous but keeps our doctor’s license safe. Our doctors are violating their Hippocratic oath – Do No Harm. They had added a caveat “except when the government is breathing down your neck. Then the patient be damned. I am glad this helped you Randy. I don’t know your clinical status but I am sure it differs from mine. Do you have severe and crippling arthritis?
Initially, inject 5 mg epidurally in the lumbar region and assess the patient in 1 hour; if pain relief is not adequate at that time, administer incremental doses of 1 to 2 mg, with sufficient time between injections to appropriately assess for efficacy. The manufacturer recommends a maximum of 10 mg per 24 hours. For continuous epidural infusion, initiate at 2 to 4 mg per 24 hours, with additional doses of 1 to 2 mg given if pain relief is not initially achieved. The incidence of early and late respiratory depression is dramatically increased with thoracic administration. Use preservative-free formulations only.
Postoperative pain relief and stress hormones were examined during the use of continuous epidural infusion of morphine at a rate of mg/hr in 30 patients (Group B) after coronary artery bypass grafting. This was compared to our routine method of postoperative analgesia of intravenous morphine 2 mg/2 hr and as needed in another 30 patients (Group A). Continuous epidural morphine infusion required occasional supplementation with intravenous morphine and achieved effective analgesia in 80% of the patients. Pain relief was adequate in 50% of the patients in Group A. The mean dose of morphine used in Group B during the first 3 postoperative days was 5 mg per patient per day and was significantly lower than that used in Group A (mean 18 mg per patient per day). Serum morphine was undetectable (below ng/ml) in Group B and was significantly lower than that in Group A (17 ng/ml). Epidural analgesia was associated with adequate postoperative pulmonary and cardiovascular functions; nausea and vomiting occurred in two patients. Levels of postoperative stress, serum cortisol, and beta-endorphin were significantly lower in Group B than in Group A. This study shows that continuous epidural infusion of morphine at a rate of mg/hr provides selective and effective pain relief and reduces postoperative stress after cardiac operations. This method of analgesia was also associated with minimal side effects and provides an alternate approach for treatment of pain after cardiac operations.