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Epidural Morphine Analgesia After Cesarean Delivery

Departments of Anesthesia, Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California.

The effectiveness and safety of 5 mg of epidurally administered morphine for postoperative analgesia was determined in 276 healthy women undergoing cesarean delivery. Overall pain relief, time to administration of additional analgesic medications, and adverse side effects were evaluated. Epidural injection of 5 mg of morphine provided good to excellent pain relief lasting 24 to 36 hours for 83% of patients. Also, review of hospital records for a subset of 34 patients revealed that requirements for additional systemic analgesics were markedly less when postoperative pain relief was provided by epidural administration of morphine than by conventional analgesia therapy. Pruritus, nausea, and vomiting occurred frequently, but were easily treated. Although late respiratory depression did not occur in this group, the authors continue to observe patients closely and monitor respiratory rates for 24 hours.

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