Postcesarean epidural morphine: A dose-response study

Craig M. Palmer, Wallace M Nogami, Gretchen Van Maren, Diane M. Alves

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

The purpose of this study was to describe the dose-response relationship of epidural morphine for postcesarean analgesia for quality of analgesia and relation to the side effects of pruritus, nausea, and vomiting. Sixty term parturients undergoing nonurgent cesarean delivery were enrolled and randomized to receive a single dose of epidural morphine after delivery (0,1.25, 2.5, 3.75, or 5 mg). A patient-controlled analgesia (PCA) device provided free access to additional analgesics. PCA morphine use and the incidence and severity of side effects were recorded for 24 h. Data were analyzed with analysis of variance, Student's t-tests, and χ2 analysis. Nonlinear regression was used to describe a dose-response curve. PCA use differed significantly among groups (P < 0.001); PCA use was significantly greater in Group 0 mg than Groups 2.5, 3.75, and 5 mg (P < 0.05). PCA use was also significantly greater in Group 1.25 mg than Groups 3.75 and 5 mg (P < 0.05). Pruritus scores were significantly higher in all groups given epidural morphine than the control group (0 mg) (P < 0.05), but did not differ among the treatment groups (1.25-5 mg), although pruritus scores were significantly higher in treatment groups than in the control (P < 0.05). No relation was found between epidural morphine dose and incidence or severity of nausea and vomiting. We concluded that, for optimal analgesia, augmentation of epidural morphine with systemic analgesics or other epidural medications may be necessary. Implications: Quality of analgesia increases as the dose of epidural morphine increases to at least 3.75 mg; increasing the dose further to 5 mg did not improve analgesia. Side effects were not dose related. For optimal analgesia, augmentation of epidural morphine with systemic analgesics or other epidural medications may be necessary.

Original languageEnglish (US)
Pages (from-to)887-891
Number of pages5
JournalAnesthesia and Analgesia
Volume90
Issue number4
StatePublished - 2000

Fingerprint

Morphine
Patient-Controlled Analgesia
Analgesia
Pruritus
Analgesics
Nausea
Vomiting
Control Groups
Epidural Analgesia
Incidence
Analysis of Variance
Parturition
Students
Equipment and Supplies
Therapeutics

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Palmer, C. M., Nogami, W. M., Van Maren, G., & Alves, D. M. (2000). Postcesarean epidural morphine: A dose-response study. Anesthesia and Analgesia, 90(4), 887-891.

Postcesarean epidural morphine : A dose-response study. / Palmer, Craig M.; Nogami, Wallace M; Van Maren, Gretchen; Alves, Diane M.

In: Anesthesia and Analgesia, Vol. 90, No. 4, 2000, p. 887-891.

Research output: Contribution to journalArticle

Palmer, CM, Nogami, WM, Van Maren, G & Alves, DM 2000, 'Postcesarean epidural morphine: A dose-response study', Anesthesia and Analgesia, vol. 90, no. 4, pp. 887-891.
Palmer, Craig M. ; Nogami, Wallace M ; Van Maren, Gretchen ; Alves, Diane M. / Postcesarean epidural morphine : A dose-response study. In: Anesthesia and Analgesia. 2000 ; Vol. 90, No. 4. pp. 887-891.
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