title: Intrathecal morphine in combination with bupivacaine: a comparative study following caesarean section.
abstract: Post operative pain is very unpleasant. Adequate analgesia during post operative period gives good patient satisfaction. To assess the adequacy of post operative analgesia in patients undergoing caesarean section. This prospective study was carried out in Lumbini Medical College, Palpa in the year, and April 2011 to October 2011. A total of 60 caesarean section cases of ASA grading I or II were selected for the study. All patients received an intrathecal injection of 0.5% (2.5 ml) hyperbaric Bupivacaine with 100 microgm and 200 microgm of preservative free morphine. Patients were monitored for 12 hours for adequacy of analgesia. Statistical analysis was done using SPSS (21) software. The median age of the patients was 22.75 (SD = 4.309).The duration of analgesia was prolonged with the patients who had 200 microgm of morphine and less with the 100 microgm of morphine which was statistically not significant (p = 0.09). The incidence of pruritus, nausea and vomiting was more with 200 microgm of morphine as compared to 100 microgm of morphine and was statically not significant (p value 0.09 and 0.373 respectively). Intrathecal morphine provides satisfactory analgesia. By decreasing the dose than what is recommended we can safely acheive adequate analgesia.
authors.affiliation: Department of Anesthesia and Critical Care, Lumbini Medical College, Pravash, Tansen, Palpa, Nepal. nilrajnp@gmail.com
authors.forename: N R
authors.initials: NR
authors.lastname: Sharma
authors.affiliation: Department of Anesthesia and Critical Care, Lumbini Medical College, Pravash, Tansen, Palpa, Nepal.
authors.forename: P
authors.initials: P
authors.lastname: Timalsena
authors.affiliation: Department of Anesthesia and Critical Care, Lumbini Medical College, Pravash, Tansen, Palpa, Nepal.
authors.forename: D C
authors.initials: DC
authors.lastname: S
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D015994:Incidence; D007278:Injections, Spinal; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000453:epidemiology; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine