title: Diamorphine analgesia after caesarean section. Comparison of intramuscular and epidural administration of four dose regimens.
abstract: In a randomised double-blind study, the efficacy, duration of action and side effects of five diamorphine analgesia regimens following Caesarean section are described. The time to next analgesia was shorter in the 5 mg intramuscular group (3.53 hours) than in any of the four epidural groups: 5 mg (5.7 hours, p = 0.007), 2.5 mg (4.76 hours, p = 0.103), 5 mg with adrenaline 1/200,000 (7.2 hours, p = 0.001) and 2.5 mg with adrenaline 1/200,000 (6.05 hours, p = 0.007). Multiple regression analysis showed that the addition of adrenaline significantly increased the duration of action of epidural diamorphine (p less than 0.05). The 5 mg dose with adrenaline showed no advantage when compared with 2.5 mg with adrenaline (p = 0.16). No serious side effects were reported in any group.
authors.affiliation: Department of Anaesthesia, Northwick Park Hospital, Harrow, Middlesex.
authors.forename: I D
authors.initials: ID
authors.lastname: Smith
authors.forename: K E
authors.initials: KE
authors.lastname: Klubien
authors.forename: M L
authors.initials: ML
authors.lastname: Wood
authors.forename: D J
authors.initials: DJ
authors.lastname: Macrae
authors.forename: F
authors.initials: F
authors.lastname: Carli
mesh_terms: D000293:Adolescent; D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D002585:Cesarean Section; D004311:Double-Blind Method; D004837:Epinephrine; D005260:Female; D003932:Heroin / Q000008:administration & dosage*; D006801:Humans; D007273:Injections, Intramuscular; D010149:Postoperative Pain / Q000517:prevention & control*; D011247:Pregnancy; D013997:Time Factors
chemical_list: D003932:Heroin; D004837:Epinephrine