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Epidural Morphine for the Relief of Postoperative Pain after Cesarean Delivery

Departments of Anesthesia, Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California.

Abstract

To determine the safety, efficacy, and dose response of epidurally administered morphine for analgesia after cesarean delivery, 40 healthy women who underwent cesarean delivery with epidural anesthesia were randomly assigned to receive one of four regimens for relief of postoperative pain: intramuscular administration of morphine, 7.5 mg (N = 10); or epidural administration of morphine, 2 mg (N = 10), 5 mg (N = 10), or 7.5 mg (N = 10). Evaluations were made of intensity and relief of pain, time to administration of additional analgesic medications, changes in vital signs and blood-gas tensions, and adverse effects. Intramuscular administration of 7.5 mg of morphine effectively relieved pain for only a short time. When morphine was administered epidurally, 2 mg proved ineffective whereas both 5 mg and 7.5 mg provided substantial pain relief for approximately 24 h. There were no significant changes in vital signs or blood-gas tensions. Side effects included pruritus and nausea, which occurred frequently but were usually mild and easily treated. We concluded that either 5 mg or 7.5 mg of morphine epidurally administered was effective and safe in providing prolonged analgesia after cesarean delivery.

Key Words: ANALGESIA: postoperative • ANALGESICS: morphine • ANESTHESIA: obstetric • ANESTHETIC TECHNIQUES: epidural • PAIN: postoperative

This article has been cited by other articles:

				B. Carvalho, E. Riley, S. E. Cohen, D. Gambling, C. Palmer, H. J. Huffnagle, L. Polley, H. Muir, S. Segal, C. Lihou, et al. Single-Dose, Sustained-Release Epidural Morphine in the Management of Postoperative Pain After Elective Cesarean Delivery: Results of a Multicenter Randomized Controlled Study Anesth. Analg., April 1, 2005; 100(4): 1150 - 1158. [Abstract] [Full Text] [PDF]

				C. M. Palmer, W. M. Nogami, G. Van Maren, and D. M. Alves Postcesarean Epidural Morphine: A Dose-Response Study Anesth. Analg., April 1, 2000; 90(4): 887 - 891. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999