Effect of a lower dose of intrathecal morphine on postoperative opioid consumption following cesarean delivery at a Texas level IV maternal care center.

Background: We hypothesized that patients who received a lower dose of intrathecal morphine (ITM) would have higher postoperative opioid consumption following cesarean delivery.

Methods: Patients who had cesarean deliveries from February 15, 2022, through February 14, 2024 at Baylor Scott & White Medical Center - Temple with single injection spinal or combined spinal epidural anesthesia who did not have labor epidural anesthesia were included. Morphine milligram equivalent (MME) opioid consumption in the first 24 postoperative hours was recorded along with patient demographic, physical, and clinical characteristics.

Results: A total of 535 and 502 patients received 0.2 and 0.15 mg ITM, respectively. Patients who received 0.15 mg ITM had higher rates of depression, scheduled cesarean deliveries, and acetaminophen administration compared to patients who received 0.2 mg ITM. Patients who received 0.2 mg ITM and 0.15 mg ITM had median (interquartile range) 24-hour MME consumption of 10.0 mg (0-30.0 mg) and 10.0 mg (0-40.0 mg), respectively (P = 0.97).

Discussion: MME consumption for 24 hours following cesarean delivery was similar between patients who received 0.2 and 0.15 mg ITM.