Postoperative pain relief in primigravida caesarean section patients--combination of intrathecal morphine and epinephrine.

Background: Uterine contraction is less severe in primigravida patients. Intrathecal coadministration of morphine and epinephrine may provide an easy way of postcaesarean pain control.

Methods: Twenty-eight primigravida patients who requested postcaesarean pain control were studied for the effectiveness of coadministration of intrathecal morphine and epinephrine. The solution for spinal anesthesia which contained 0.2 mg morphine, 0.1 mg epinephrine and 10 mg hyperbaric bupivacaine was injected intrathecally. Another 30 primigravida patients were collected randomly as control. In the control group, normal saline and 0.1 mg epinephrine were used with bupivacaine. Side effects from intrathecal morphine and the need of analgesia were recorded within 48 h.

Results: In the study group, 89.3% (25/28) of patients did not need further narcotics for pain relief during their hospitalization after caesarean section. 96.4% (27/28) of patients needed only one dose of 50 mg intramuscular meperidine (Demerol) or no narcotic at all for pain relief within 48 h. No respiratory depression occurred. In the control group, each patient received in the average 6-7 doses of 50 mg Demerol for pain control within 48 h.

Conclusions: Our results showed that 0.2 mg morphine and 0.1 mg epinephrine in combination with 10 mg hyperbaric bupivacaine given intrathecally could provide a simple way of pain control in primigravida patients undergoing caesarean section.