Epidural morphine for the control of pain after cesarean section

Epidural morphine was evaluated for the control of postoperative pain after cesarean section (CS). Sixty-five patients undergoing elective CS with epidural bupivacaine were studied. Of these, 40 were given a single dose of 4 mg of morphine through an epidural catheter on termination of surgery. The remaining 25 patients received no postoperative epidural medication. In all cases, the catheters were withdrawn before the patients left the operating theater and 15 mg doses of papaveretum (OMNOPON) ordered as required for pain relief. The ward staff was unaware of the study. The time between the termination of surgery and the first administration of postoperative narcotic was noted, as was the total dose, for 48 h. The epidural morphine was associated with a prolonged period of postoperative analgesia and a greatly reduced total papaveretum requirement for the 48 h (30.9 mg for the study group in contrast to 67.6 mg for the controls). The difference between the two groups was significant (P less than 0.001). We concluded that epidural morphine is an efficient method for the control of postoperative pain following CS, a single dose of 4 mg providing relief from pain for 8 to 12 h and sometimes longer.