Comparison of the Efficacies of Three Different Intrathecal Doses of Morphine in Achieving Postcesarean Delivery Analgesia


Tamdoğan İ., Turunç E., Kocamanoğlu İ. S.

Journal of Perianesthesia Nursing, cilt.38, sa.5, ss.717-723, 2023 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 38 Sayı: 5
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1016/j.jopan.2022.11.015
  • Dergi Adı: Journal of Perianesthesia Nursing
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, EMBASE, MEDLINE, DIALNET
  • Sayfa Sayıları: ss.717-723
  • Anahtar Kelimeler: analgesia, cesarean section, morphine, postoperative pain, spinal anesthesia
  • Ondokuz Mayıs Üniversitesi Adresli: Evet

Özet

Purpose: The objective of this study is to compare the efficacies of 3 different intrathecal doses (80, 120, and 160 mcg) of morphine in achieving postcesarean delivery analgesia and the severity of the side effects thereof. Design: A prospective, randomized, double-blind study. Methods: A total of 150 pregnant women between the ages of 18 to 40, with a gestational week >36, who were planned to have elective cesarean section were included in the study. Patients were randomized into 3 groups based on the dosages of intrathecal doses of morphine (80, 120, and 160 mcg) they will receive in addition to 10 mg 0.5% hyperbaric bupivacaine and 20 mcg fentanyl. Intravenous (IV) patient-controlled analgesia (PCA) prepared with fentanyl was administered to each patient after the surgery. Postoperative 24-hour total IV PCA-fentanyl consumption was recorded. The patients were evaluated for side effects such as pain, nausea-vomiting, pruritus, sedation score, and respiratory depression after the surgery. Findings: PCA-fentanyl consumption was significantly higher in Group 1 compared to Group 2 and 3 (P = .047). There was no significant differences between the groups in terms of nausea-vomiting scores. The pruritus scores were significantly higher in Group 3 compared to Group 1 (P = .020). The pruritus scores were significantly higher in all groups at the postoperative 8th-hour (P = .013). Respiratory depression, which would require treatment, was not observed in any patient. Conclusions: Based on the study findings, it was concluded that 120 mcg intrathecal morphine provides adequate analgesia with minimal side effects in cesarean sections.