Single-Dose, Sustained-Release Epidural Morphine in the Management of Postoperative Pain After Elective Cesarean Delivery: Results of a Multicenter Randomized Controlled Study
- 1 April 2005
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Anesthesia & Analgesia
- Vol. 100 (4), 1150-1158
- https://doi.org/10.1213/01.ane.0000149544.58230.ff
Abstract
In this multicenter, randomized, controlled study, we compared the analgesic efficacy and safety profile of a new single-dose extended-release epidural morphine (EREM) formulation (DepoDur) with that of epidural morphine sulfate for the management of postoperative pain for up to 48 h after elective cesarean delivery. ASA physical status I or II parturients (n = 75) were anesthetized with a combined spinal/epidural technique. Parturients received intrathecal bupivacaine 12-15 mg and fentanyl 10 mug for spinal anesthesia and a single epidural injection of either 5 mg of standard (conventional preservative-free) morphine or 5, 10, or 15 mg of extended-release morphine after cord clamping for postoperative pain control. Single-dose EREM 10 and 15 mg groups significantly decreased total supplemental opioid medication use and improved functional ability scores for 48 h after surgery compared with those receiving 5 mg of standard morphine. Visual analog scale pain scores at rest and with activity at 24 to 48 h after dosing were significantly better in the 10- and 15-mg single-dose EREM groups versus the standard morphine group. There were no significant differences between the two 5 mg (single-dose EREM and standard morphine) groups. Single-dose EREM was well tolerated, and most adverse events were mild to moderate in severity. Single-dose EREM is a potentially beneficial epidural analgesic for the management of post-cesarean delivery pain and has particular advantages over standard morphine for the period from 24 to 48 h after surgery.Keywords
This publication has 6 references indexed in Scilit:
- Pain relief and safety after major surgery A prospective study of epidural and intravenous analgesia in 2696 patientsActa Anaesthesiologica Scandinavica, 2003
- Cost‐effectiveness of analgesia after Caesarean section. A comparison of intrathecal morphine and epidural PCAActa Anaesthesiologica Scandinavica, 2002
- Small Doses of Intrathecal Morphine Combined with Systemic Diclofenac for Postoperative Pain Control After Cesarean DeliveryAnesthesia & Analgesia, 1998
- More than just pain relief: A study of postpartum, post-caesarean pain managementAustralian College of Midwives Incorporated Journal, 1996
- Epidural opioid analgesia after Caesarean section: a comparison of patient-controlled analgesia with meperidine and single bolus injection of morphineCanadian Journal of Anesthesia/Journal canadien d'anesthésie, 1994
- Epidural morphine for analgesia after Caesarean section: a report of 4880 patientsCanadian Journal of Anesthesia/Journal canadien d'anesthésie, 1990