Much of the burden of surgical disease in Papua New Guinea presenting to Alotau General Hospital serving Milne Bay Province can be effectively treated by a small team providing emergency and essential surgical care. This is despite a relatively low surgical volume and limited numbers of trained surgical anaesthesia obstetric providers, and likely underservicing. The ability of surgical care to avert disease in Papua New Guinea highlights its importance to public health in LMICs.

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In order to introduce the technique 0/ epidural narcotics/or pain relie/in Papua New Guinea,fifty patients were given low doses 0/ epidural morphine and thereupon the quality 0/ analgesia and morbidity evaluated. The lowest effective epidural morphine dose was determined by considering the patient's characteristics and height 0/ surgical incision. Pain relie/ was provided /or three postoperative days in the surgical or gynaecological wards. The quality 0/ analgesia thus provided was excellent in all the patients with no incidence 0/ clinically significant respiratory depression or hypotension. Minor complications such as nausea, vomiting, pruritis and retention 0/ urine were also relatively uncommon.