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Epidural morphine vs hydromorphone in post-caesarean section patients
S H Halpern1, R Arellano, R Preston
1Department of Anaesthesia, Women's College Hospital, Toronto, Ontario, Canada. halpern@ftn.net
Purpose:
The purpose of this randomized controlled double blind study was to compare the efficacy of pain relief and the side effects of epidural hydromorphone and morphine in post-Caesarean patients.
Methods:
In all patients, epidural anaesthesia was induced using carbonated lidocaine 2% with 1:200,000 epinephrine and 50 micrograms fentanyl, given in incremental doses. Patients in Group 1 (n = 24) received 0.6 mg hydromorphone and patients in Group 2 (n = 22) received 3 mg morphine after delivery of the infant. Pain, pruritus and nausea were measured using a visual analog scale (at times: baseline, on admission to the recovery room, 3, 6, 12, 18 and 24 hr postoperatively), by the number of requests for additional medications and by an overall satisfaction score.
Results:
There was no difference between the groups in pain relief of in the incidence and severity of side effects. Pruritus was more pronounced within the first six hours in Group 1 and at 18 hr in Group 2.
Conclusion:
Hydromorphone provides no clinical benefit over epidural morphine for post operative analgesia following Caesarean section.