title: Epidural morphine vs hydromorphone in post-caesarean section patients.
abstract: OBJECTIVE
  The purpose of this randomized controlled double blind study was to compare the efficacy of pain relief and the side effects of epidural hydromorphone and morphine in post-Caesarean patients.
  
  
  METHODS
  In all patients, epidural anaesthesia was induced using carbonated lidocaine 2% with 1:200,000 epinephrine and 50 micrograms fentanyl, given in incremental doses. Patients in Group 1 (n = 24) received 0.6 mg hydromorphone and patients in Group 2 (n = 22) received 3 mg morphine after delivery of the infant. Pain, pruritus and nausea were measured using a visual analog scale (at times: baseline, on admission to the recovery room, 3, 6, 12, 18 and 24 hr postoperatively), by the number of requests for additional medications and by an overall satisfaction score.
  
  
  RESULTS
  There was no difference between the groups in pain relief of in the incidence and severity of side effects. Pruritus was more pronounced within the first six hours in Group 1 and at 18 hr in Group 2.
  
  
  CONCLUSIONS
  Hydromorphone provides no clinical benefit over epidural morphine for post operative analgesia following Caesarean section.
authors.affiliation: Department of Anaesthesia, Women's College Hospital, Toronto, Ontario, Canada. halpern@ftn.net
authors.forename: S H
authors.initials: SH
authors.lastname: Halpern
authors.forename: R
authors.initials: R
authors.lastname: Arellano
authors.forename: R
authors.initials: R
authors.lastname: Preston
authors.forename: J
authors.initials: J
authors.lastname: Carstoniu
authors.forename: G
authors.initials: G
authors.lastname: O'Leary
authors.forename: S
authors.initials: S
authors.lastname: Roger
authors.forename: A
authors.initials: A
authors.lastname: Sandler
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D004091:Hydromorphone / Q000009:adverse effects / Q000627:therapeutic use*; D015994:Incidence; D008012:Lidocaine / Q000008:administration & dosage; D009020:Morphine / Q000009:adverse effects / Q000627:therapeutic use*; D009325:Nausea / Q000139:chemically induced; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D011247:Pregnancy; D011537:Pruritus / Q000139:chemically induced
chemical_list: D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D009020:Morphine; D008012:Lidocaine; D004091:Hydromorphone; D005283:Fentanyl