Question:
Epidural vs. Morphine Pump

I'm having open RNY surgery in 5 days and I found out that I have an option with the pain control choices. What are the pros and cons with the epidural and the morphine pump? Is the epidural riskier? Will I have less pain with the epidural? I don't want to add another unnecessary complication to my surgery!    — Sandy V. (posted on October 14, 2000)

October 14, 2000
From a clinical standpoint, the epidural has a higher risk factor because it is a more invasive procedure. However, it is a frequently used and high successful form of pain management. Contrary to epidurals used in childbirth, which generally numb the legs and make walking difficult or impossible, epidurals used for post-operative pain management alleviate pain without causing over-sedation, do not cause total numbing, and do allow patients to be mobile. The morphine pump is also an excellent pain management tool, but will cause patients to be more sleepy and sedated. Some individuals will not consider an epidural due to their anxiety about "spinal anesthesias" in general; however the complication rate for epidurals is very small. Either choice will give you what you want: relief from post-op pain. Good luck!
   — Diana T.

October 14, 2000
Sandy, I didn't have a choice (I had the morphine pump), but if I did, I would not choose the epidural. I had one for the birth of my second daughter. The injection is given in the spine and it hurts like a massive bee sting. I guess I'd have a different opinion if actually was effective on me, but it was not. I think the anesthesologist missed the mark, so I felt everything as if I had no painkillers at all! The morphine is piggybacked to your IV, so there is no further pain associated with it. Just my .02....Good Luck.
   — Allie B.

October 14, 2000
Hi Sandy, I had an epidural and loved it! It was wonderful. I had no pain from start to finish. When I woke up from surgery, the epidural was already flowing & I felt nothing. I've heard so many stories about people waking up in terrible pain & having to wait for the nurse to give the meds. I also had an epidural for the birth of my boys, but this was very different. No numbness, etc. After 3 days, they took out my epidural & put me on demoral in my main line. That was great too! Love that Demoral! After 3 days of that, they put me on Vicoden to go home with. I took it for a couple days and that was it. No pain..start to finish. Good luck with your choice!
   — [Deactivated Member]

October 14, 2000
Sandy, I had the epidural inserted before surgery and it hurt a lot. I woke up in recovery and it didn't work. I was crying begging them to let me die it hurt so bad. They then inserted a morphine pump and I was so happy , I could have cried. I will never trust anyone to put in an epidural in me again. I am sure it was just my bad luck , but it was inserted twice and failed both times , for me the morphine pump is the only way to go now.Good luck whichever you decide and speedy recovery.
   — Heather T.

October 14, 2000
I was terrified of the epidural before surgery, and had made up my mind to have the morphine pump. The day of surgery a team of anesthesiologists came to me very concerned about my choice. They explained that because the surgery is so high up in the chest and is so painful, patients do not want to breathe properly when they have morphine. They told me all of the complications that I would probably have if I decided not to have an epidural. They scared the crap out of me, and I decided to have it done. They took me into the OR, had me sit on the table kind of hunched over, and put a little numbing medicine in my back. A nurse held my hand because I was crying a bit due to fear. Then they brought in a fluoroscope, a large X ray machine that shows images in real time. They used this to see the exact position of the epidural. It did not hurt going in, I was startled once by a bit of pressure, but no pain. They checked it before surgery to make sure I was numb in all the right places. It was working, and they knocked me out and got on with the surgery. **When I woke up, I was utterly amazed at how little pain I was in. My IV's hurt, my foot hurt, my incision did not hurt at all. I was able to breathe, and I was alert and aware like I never was before with the morphine.*** They kept it in for 3 more days, and the tape they used to keep it in place worked just fine. I also got a demand button to use if I needed an extra shot. Having had both methods of pain control, I will use epidurals from now on. I hope this helps you make your decision.
   — Cara S.

October 16, 2000
I had the epidural AND the morphine pump. I do not regret my decision. Best wishes.
   — [Deactivated Member]

March 21, 2003
I am a nurse in the surgical unit, and I will tell you that 95% of the time epidurals are better for abdominal surgical patients. I have never seen one patient who didn't love it. They can walk (for rapid recovery you have to walk a lot!) without pain, and usually say, "This epidural is great; I can't believe I have no pain!" On the otehr hand those who have a regular morphine PCA drip, are normally having peaks and valleys in pain control, and they sleep A LOT! They have lots of side effects to the morphine (profuse sweating that requires the linens be changed, and the patients hate that cuz they have to move which causes more pain!, nausea, dizziness, and frequently sleep.). Don't get me wrong, morphine PCA can be a good drug for pain control, but it's second to epidural. And, if the epidural doesn't work, they can easily switch to the morphine PCA drip; it just goes through the IV. Talk to your anesthesiologist and surgeon about this.
   — Laura H.

March 30, 2003
I think that everyone's pain tolerance is different. I don't tolerate morphine well at all. I did have something else Delauded (?)in my PCA pump. When that was removed, I was offerred 2 Percosets every 4 hours. I took them as they were offerred. It made me groggy and more able to sleep. Well, a day after I came home, I was back in the ER. I was impacted, and dehydrated from all the meds. Be aware that this can be a side effect of the narcotice used to control pain. I was in for 4 extra days until my bowels were finally able to "move" again. SAy NO to drugs if you can!!!!!!
   — Fixnmyself