title: Analgesia after Cesarean delivery: a retrospective comparison of intrathecal hydromorphone and morphine.
abstract: OBJECTIVE
  To compare analgesia and opioid-related side effects of intrathecal morphine and intrathecal hydromorphone after elective Cesarean delivery.
  
  
  METHODS
  Retrospective, comparative study.
  
  
  METHODS
  Labor and delivery unit of an academic hospital.
  
  
  METHODS
  114 parturients age ≥ 18 years, presenting for elective Cesarean delivery.
  
  
  METHODS
  Patients who received 0.04 mg intrathecal hydromorphone were compared to a random sample of patients who received 0.1 mg intrathecal morphine for postoperative analgesia.
  
  
  METHODS
  The primary outcome was the presence of any opioid-related complication (pruritus, nausea or vomiting, respiratory depression) requiring treatment within 24 hours of intrathecal opioid administration. Secondary outcomes included total opioid consumption (in oral morphine equivalents) within 24 hours of intrathecal opioid administration and verbal pain score (0 = none, 10 = worst) at 4, 8, 12, 18, and 24 hours after intrathecal opioid administration.
  
  
  RESULTS
  38 patients who received intrathecal hydromorphone 0.04 mg were compared with 76 patients given 0.1 mg of intrathecal morphine for elective Cesarean delivery. No significant differences in demographics were noted between groups. There were no statistically significant differences between the intrathecal hydromorphone and intrathecal morphine groups in overall frequency of opioid-related complications (50% vs. 34.2%; P = 0.11), 24-hour opioid consumption (33 mg oral morphine equivalent [OME] vs. 8 mg OME; P = 0.27), or pain scores at any time point up to 24 hours.
  
  
  CONCLUSIONS
  Overall, analgesia and incidence of opioid-related side effects after 0.04 mg of intrathecal hydromorphone did not differ statistically from 0.1 mg of intrathecal morphine.
authors: Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
authors: Nicole C
authors: NC
authors: Beatty
authors: Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
authors: Katherine W
authors: KW
authors: Arendt
authors: Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
authors: Adam D
authors: AD
authors: Niesen
authors: Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
authors: Erica D
authors: ED
authors: Wittwer
authors: Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA. Electronic address: jacob.adam@mayo.edu.
authors: Adam K
authors: AK
authors: Jacob
mesh_terms: D000328:Adult; D016362:Analgesia, Obstetrical / Q000009:adverse effects / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D002585:Cesarean Section; D005260:Female; D006801:Humans; D004091:Hydromorphone / Q000008:administration & dosage* / Q000009:adverse effects; D007278:Injections, Spinal; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D009325:Nausea / Q000139:chemically induced / Q000453:epidemiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D011247:Pregnancy; D011537:Pruritus / Q000139:chemically induced / Q000453:epidemiology; D012131:Respiratory Insufficiency / Q000139:chemically induced / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D014839:Vomiting / Q000139:chemically induced / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D004091:Hydromorphone
keywords: Cesarean delivery; Efficacy; Intrathecal analgesia; Intrathecal hydromorphone; Intrathecal morphine; Side effects