title: Epidural diamorphine for post-caesarean pain: a dose response study.
abstract: The effectiveness of postoperative pain relief and the frequency of side effects with three different doses of epidural diamorphine (2.0, 3.5 and 5 mg) was investigated. The study was carried out double-blind in 30 women undergoing awake elective caesarean section. Postoperative pain intensity was measured on a linear analogue scale. The time to onset of analgesia (TOA), time taken to reach a pain score of zero or become comfortable, and time to next analgesia (TNA) were not significantly different between groups. Three patients in the 2 mg group failed to achieve scores of zero but were comfortable. No nausea or vomiting was seen but the incidence of itching was 0, 30% and 80% in the 2.0, 3.5 and 5 mg groups respectively. We conclude that epidural diamorphine 2 mg is adequate for relief of post-caesarean pain and higher doses may increase the incidence of unwanted side-effects.
authors.affiliation: Nuffield Department of Anaesthetics, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK.
authors.forename: M T
authors.initials: MT
authors.lastname: Popat
authors.forename: T
authors.initials: T
authors.lastname: Tipping
authors.forename: N H
authors.initials: NH
authors.lastname: Kay