title: Efficacy of single dose epidural morphine versus intermittent low-dose epidural morphine along with bupivacaine for postcaesarean section analgesia.
abstract: BACKGROUND
  Obstetric anesthesia presents a challenge to the anesthesiologist. The effective pain management allows the partu-rient adequate degree of comfort and promotes physical reco-very and a sense of well being.
  
  
  METHODS
  This randomized controlled study was designed to assess the analgesic efficacy and side effects of 1.20 mg single-dose epidural morphine (Group 1) versus intermittent 12 hourly epidural morphine (0.5 mg) with bupivacaine (Group2) for postoperative analgesia in lower segment caesarean section cases.
  
  
  RESULTS
  Each group consisted of 36 patients. Demographic characteristics of two groups were comparable and differences among them were not statistically significant. Mean duration of analgesia was significantly longer in group one patients (16.5±2.5h) in comparison to group two patients (11.5±1.5h). Mean highest visual analog scales (VAS scale) was significantly lower (3.2±0.9) in group one patients in comparison of group two (6.7±0.8) patients. Only 43% patient in group one required supplementary perenteral analgesic (Paracetamole/Diclofenac) and 71% required epidural morphine/bupivacaine in group two. Mean number of supplementary perenteral analgesic required in group one was 0.7 and it was 1.8 in group two. There was no significant difference in nausea, vomiting, itching, and pruritis in two groups of patients.
  
  
  CONCLUSIONS
  Our study showed that the use of single dose epidural morphine is associated with lower pain scores at rest and movement when compared to intermittent epidural morphine with bupivacaine in postcaesarean section analgesia.
authors.affiliation: Department of Obstetrics and Gynecology, Rohilkhand Medical College, Bareilly, Uttar Pradesh, India.
authors.forename: Kiran
authors.initials: K
authors.lastname: Agarwal
authors.affiliation: Department of Anesthesia Honorary Consultant Anesthesia, Rohilkhand Medical College, Bareilly, Uttar Pradesh, India.
authors.forename: Navneet
authors.initials: N
authors.lastname: Agarwal
authors.affiliation: Department of Community Medicine, Rohilkhand Medical College, Bareilly, Uttar Pradesh, India.
authors.forename: V K
authors.initials: VK
authors.lastname: Agrawal
authors.affiliation: Department of Pediatrics, Rohilkhand Medical College, Bareilly, Uttar Pradesh, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Agarwal
authors.affiliation: Department of Community Medicine, Rohilkhand Medical College, Bareilly, Uttar Pradesh, India.
authors.forename: Mahender
authors.initials: M
authors.lastname: Sharma
keywords: Caesarean section; epidural analgesia; morphine