Combined intrathecal morphine and bupivacaine for cesarean section.
The effects of adding 0.2 mg preservative-free morphine sulfate in 0.2 ml solution to hyperbaric spinal bupivacaine were evaluated in a double-blind randomized prospective study of 34 patients undergoing elective repeat cesarean section. In the control patients (n = 17), 0.2 ml saline instead of morphine was added to bupivacaine. The intrathecal morphine significantly improved intra- and postoperative analgesia, e.g., 82% of patients given morphine compared with 41% of the control patients did not require analgesic supplementation to the spinal anesthesia during surgery; postoperatively, the former patients did not request additional analgesia for 27 +/- 0.7 hours (mean +/- SEM) compared with 2 +/- 0.3 hours in the control patients. Neonatal condition was not adversely affected by this small dose of morphine administered 11 +/- 1 minutes before delivery. Combining 0.2 mg morphine with hyperbaric spinal bupivacaine for cesarean section is a safe and effective method of improving intraoperative pain relief and providing adequate prolonged postoperative analgesia.
Abouleish
E
E
Department of Anesthesiology, University of Texas Health Science Center, Houston 77030.
Rawal
N
N
Fallon
K
K
Hernandez
D
D
D000698:Analgesia; D000773:Anesthesia, Obstetrical / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage*; D002585:Cesarean Section; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D009020:Morphine / Q000008:administration & dosage*; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D012119:Respiration / Q000187:drug effects
D004338:Drug Combinations; D009020:Morphine; D010100:Oxygen; D002045:Bupivacaine