Reducing of Postoperative Nausea and Vomiting in Patients Undergoing Elective Cesarean Section with Spinal Morphine 0.08 mg Comparison with Spinal Morphine 0.2 mg
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Abstract
Background: 0.2 mg of spinal morphine for postoperative
cesarean section provides good analgesia, but nausea
and vomiting are common side effects.
Objectives: This study aimed to compare nausea and
vomiting, other side effects and effectiveness between
0.08 mg and 0.2 mg spinal morphine during 24 hours post
operation.
Methods: Seventy-four patients undergoing elective
cesarean section were enrolled and randomized into two
groups; 0.08 mg (n=37) or 0.2 mg (n=37) of morphine
added to 10.5 mg heavy bupivacaine. Nausea vomiting
severity, time to first tramadol requirement, total tramadol
used, pain scores and other side effects were recorded in
24 hours post operation.
Results: Demographic data were similar between the two
groups. The incidence of postoperative nausea and vomiting
(PONV) in the study group and control group were not
different (40.5% vs 37.8%; p = 0.812). There was no
difference related to severity of PONV, time to first
analgesic requirement, and pruritus. The differences
between the two groups were tramadol consumption and
pain scores. In 0.08 mg group, patients had significantly
higher pain scores (P<0.001) and tramadol consumption
(P = 0.011).Conclusions: Reducing morphine dosage from 0.2 mg to
0.08 mg for spinal analgesia combined with heavy
bupivacaine in elective cesarean section is not decreased
severity of postoperative nausea and vomiting but
significantly higher pain scores and total tramadol used.
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