Comparison of 3 Doses Intrathecal Morphine for Post Caesarean Section Analgesia
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Abstract
Objective: To evaluate and compare post operative analgesia and side effect of 3 doses intrathecal morphine
Research design: Randomize-controlled trial (RCT)
Setting: Operation room and obstetric ward in Surin Hospital
Subjects: One hundred and two term pregnancies with age 16-45 years, ASA physical status I II under went caesarean section at operative room, Surin Hospital.
Method: 102 term pregnancies, scheduled for Caesarean section, were randomly allocated into 3 double blinded groups. Group 1, group 2, group 3, received intrathecal morphine 0.1 mg, 0.2 mg, 0.3 mg respectively. Pain score, analgesia duration, Intravenous tramal injection and morphine-related side effect (respiratory depression, post operative nausea, vomiting, pruritus and sedation) were recorded for 24 hours postoperation.
Statistical analysis: One-way anova, Chi-square test
Result: The study review, Pain free duration of group 2, group 3 were significantly longer than group 1. Postoperative analgesia duradon of group 3 was significantly longer than group 1. Total tramal requirements of group 3 was significantly lower than group 1. VNS at 4, 8, 12 hours postoperative of group 2, group 3 were significantly lower than group 1.There is no signifi¬cant difference in incidence of pruritus, nausea, vomiting of three groups. None of the patient in all groups developed respiratory depression.
Conclusion: The result indicates that 0.3 mg of intrathecal morphine is the optimal dose for post operative pain relief in caesarean section. However, the side effects were more frequent in the higher morphine group but not serious and symptomatically treatable.
Key words: Intrathecal morphine, Postcaesarean section analgesia, VNS (Verbal numeri¬cal pain score)
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References
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