Title: Epidural analgesia with 4 mg of morphine following caesarean section: effect of injected volume
Abstract: The efficacy and side effects of epidural bolus injection of 4 mg of morphine in a volume of 2 ml, 10 ml, or 20 ml (groups I, II and III) for postoperative analgesia after caesarean section (60 patients) were evaluated. All patients had epidural anaesthesia established up to T4 level with 0.5% bupivacaine 18–20 ml, supplemented with 2% lidocaine with adrenaline, when necessary. Morphine 4 mg in either of the three volumes was injected through the epidural catheter in random order after delivery of the baby. Six patients in each group reported no pain during the 24‐h follow‐up period. No additional pain medication during the 24 h after surgery was required in 11, 14 and 10 patients in groups I, II and III, respectively. Most of the others managed with the addition of a single dose of rectal ketoprofen. There were no differences in analgesic therapy between the groups. Pruritus was the most common adverse effect (18/20, 19/20 and 18/20 in groups I, II and III, respectively). 10/20, 12/20 and 14/20 (N.S.) patients had nausea and vomiting in groups I, II and III, respectively. Metoclopramide, prescribed for persistent nausea, was given to 4/20 patients in group I, 6/20 patients in group II and 9/20 patients in group III (N.S.). After removal of the urinary catheter 7/20 patient in group III required carbachol for urinary retention compared to 3/20 and 4/20 patients in groups I and II (N.S.). In this study a tenfold dilution of 4 mg of morphine did not influence the quality of analgesia after caesarean section or cause statistically significant differences in the appearance of side‐effects.
Publication Year: 1993
Publication Date: 1993-11-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 17
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