• Anesthesia and analgesia · Jan 2010

    Randomized Controlled Trial

    A randomized, double-blind, placebo-controlled trial of epidural morphine analgesia after vaginal delivery.

    • Alison Macarthur, Charles Imarengiaye, Luminita Tureanu, and Kristi Downey.
    • Department of Anesthesia, University of Toronto, Toronto, ON, Canada. alison.macarthur@uhn.on.ca
    • Anesth. Analg. 2010 Jan 1;110(1):159-64.

    BackgroundPain after vaginal delivery can interfere with the activities of daily living. We hypothesized that epidural medication administered after delivery would be of benefit for acute postpartum pain management. The objective of this study was to assess whether epidural morphine after vaginal delivery would reduce the analgesic requirements for perineal pain.MethodsThis randomized, double-blind, placebo-controlled trial included 228 parturients who received epidural morphine, 2.5 mg, or epidural saline within 1 h of delivery. The primary outcome was the proportion of women who received additional analgesics in the first 24 h postpartum. We also evaluated the time to first request for analgesia, pain and satisfaction scores, and the incidence of side effects due to epidural morphine.ResultsThe majority of the 228 women participating in the study were Caucasian, primiparous patients >30 yr old. The proportion of women requiring additional analgesics was less among those who received epidural morphine (8 of 113; 7%) compared with saline (37 of 115; 32%), regardless of the degree of perineal trauma (RR = 0.22, 95% CI: 0.12-0.41). The relative risk reduction in receiving additional analgesics for primiparous patients receiving epidural morphine compared with saline was 0.25 (95% confidence interval [CI]: 0.13-0.49) and for multiparous women was 0.12 (95% CI: 0.02-0.63). The time to first request for analgesics was later for those who received morphine (mean 22.9 h, 95% CI: 22.2-23.7) compared with saline (mean 18.9 h, 95% CI: 17.4-20.4) (P < 0.0001). The side-effect incidence (pruritus, nausea and vomiting, and sedation) was not different between the 2 groups.ConclusionThere was a 78% reduction in analgesic requirements in women given epidural morphine after vaginal delivery compared with placebo for both primiparous and multiparous patients. Women who receive epidural labor analgesia for vaginal deliveries and stay in the hospital for 24 h after delivery may benefit from postpartum administration of epidural morphine.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…