Epidural analgesia with 4 mg of morphine after caesarean section: modulating effect of epidural block compared to general anaesthesia.
Forty patients had epidural catheters placed for analgesia in active labour. For caesarean section patients in the epidural (EA) group (n = 20) had epidural anaesthesia with 0.5% bupivacaine supplemented if necessary with 2% lidocaine with adrenaline. Patients in the general anaesthesia (GA) group (n = 20) had standardized general anaesthesia for surgery. In both groups 4 mg of morphine in 8 ml of 0.25% bupivacaine was given epidurally after delivery of the baby. During the first 3 h of the postoperative period, as long as the epidural block was effective, patients in the EA group experienced significantly less pain. At 6, 12 and 24 h pain estimations were equal in both groups. Patients in the EA group consumed significantly less pain medication during the first 24 h after surgery (P = 0.0002). Itching was less frequent in the GA group (P = 0.011). It is concluded that epidural administration of 4 mg of morphine produces more effective postoperative pain relief when emergency caesarean section is conducted under epidural than when it is conducted under general anaesthesia.
Asantila
R
R
Department of Anaesthesia, Helsinki Maternity Hospital and Helsinki University Central Hospital, Finland.
Eklund
P
P
Latvala
H
H
Rosenberg
P H
PH