Epidural morphine for postoperative analgesia after Caesarean section

Introduction

This prospective randomized double-blind study compared the effectiveness and duration of analgesia of epidural morphine 4 mg and 5 mg for postoperative analgesia after Caesarean section.

Materials and methods

Sixty ASA I and II patients were randomized into 2 groups, Group A received epidural morphine 4 mg while Group B received epidural morphine 5 mg. All patients were provided with patient controlled analgesia (PCAM), for use as rescue analgesia. Pain was assessed using visual analogue score at 4, 8, 12, 16, 20 and 24 h. Time to first demand of patient controlled analgesia, cumulative morphine consumption and side effects were documented.

Results

The VAS for pain was significantly lower in Group B at 16, 20 and 24 h. The mean cumulative PCAM consumption was significantly lower in Group B. The incidence of nausea, vomiting (PONV) and pruritus was significantly higher in Group B, p < 0.05. There was no incidence of excessive sedation or respiratory depression.

Conclusion

Epidural morphine 5 mg provided adequate and longer duration of analgesia but resulted in higher frequency of pruritus and vomiting.