Painless lumbar surgery: morphine nerve paste.

The intraoperative application of morphine as a nerve paste to the exposed dura and nerve roots in lumbar cases provides immediate, dramatic, and long-term relief in postoperative pain. Fifty-four patients with intractable sciatica due to ruptured discs or lumbar stenosis were treated. After decompression of the involved nerve root(s), a paste composed of Avitene, Depo-medrol, Amicar, and Duramorph is applied to the local epidural space. No catheter is required. The Duramorph does not need to be replenished. The use of the nerve paste reduces hospital stay to a minimum, reduces the stress of surgery, and has not produced undesirable side-effects.