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Urinary function during epidural analgesia with methadone and morphine in post-cesarean section patients
Shmuel Evron1, Arnon Samueloff, Alex Simon
1Department of Obstetrics and Gynecology, Hadassah university Hospital and Hebrew University-Hadassah Medical School, Jerusalem 91120 Israel Department of Anesthesia, Hadassah university Hospital and Hebrew University-Hadassah Medical School, Jerusalem 91120 Israel.
Pain
|October 1, 1985
Summary
Epidural methadone significantly improved urinary function and reduced catheterization needs in women after cesarean delivery, offering potent pain relief with fewer urinary disturbances compared to morphine or non-opiate analgesics.
Area of Science:
- Anesthesiology
- Urology
- Obstetrics
Background:
- Post-cesarean delivery pain management often involves epidural anesthesia.
- Urinary dysfunction is a common complication following cesarean section.
- Opioid and non-opioid analgesics can impact postoperative urinary function.
Purpose of the Study:
- To evaluate the effect of epidural methadone versus epidural morphine and non-opiate analgesics on urinary function after cesarean section.
- To compare the incidence of micturition difficulties and need for bladder catheterization among different analgesic regimens.
Main Methods:
- A comparative study involving 120 women undergoing cesarean section under epidural anesthesia.
- Patients received postoperative analgesia via epidural methadone (40), epidural morphine (40), or non-opiate analgesics (40).
- Urinary function, including urine volume, time to first voiding, and micturition difficulties, was assessed postoperatively.
Main Results:
- Epidural methadone significantly increased urine volumes and shortened the time to first voiding compared to epidural morphine and non-opiate analgesics.
- The incidence of difficulty in micturition and need for bladder catheterization was substantially lower with epidural methadone (2.5%) versus morphine (57.5%) or non-opiate analgesics (12.5%).
- Both methadone and morphine provided effective postoperative pain relief.
Conclusions:
- Epidural methadone is a highly effective analgesic for postoperative pain management after cesarean delivery.
- Epidural methadone demonstrates a superior profile in preserving urinary function and reducing urinary complications compared to epidural morphine and non-opiate analgesics.
- The use of epidural methadone is advocated for its dual benefits of potent analgesia and minimal urinary disturbances.