Intrathecal administration of hyperbaric morphine for the relief of pain in labour

Thirty healthy women in active labour received an intrathecal injection of morphine 0.5 mg (n = 12) or 1 mg (n = 18) in 7.5% dextrose. Both doses provided excellent analgesia for labour, 93% of patients obtaining at least 50% pain relief. Analgesia began 15-60 min after injection and did not decrease until 6-8 h after injection. Analgesia was satisfactory until distension of the perineum, either by forceps or the infant's head. The intrathecal injection of morphine did not adversely affect the condition of the infant. Eighty per cent of patients developed pruritus; 53%, nausea or vomiting, or both; 43%, urinary retention; and 43%, drowsiness. These side effects were decreased by naloxone, which did not affect the degree of analgesia. There was no significant depression of ventilation in any patient. These results suggest that morphine 0.5 mg or 1 mg, administered intrathecally, effectively decreases the pain of labour, and that i.v. administration of naloxone can alleviate the common side effects.