Objectives:

Spinal anesthesia is the most commonly used anesthesia technique in cesarean sections and intrathecal opioids are frequently used for pain control. Intrathecal morphine provides effective and long-term pain control in the postoperative period. The aim of our study was to compare the intrathecal two different morphine doses in terms of additional analgesic need, patient satisfaction, and side effects.

Materials and Methods:

A total of 165 American Society of Anesthesiologists (ASA) I-II patients who will undergo elective cesarean section at Ankara University Faculty of Medicine, Gynecology and Obstetrics Hospital were included in the study. The study was designed as prospective, randomized and double-blind. The pregnant women were randomly alloceted into three groups to receive either 50 or 100 μg intrathecal morphine and the control group. All patients were anesthetized with 10 mg hyperbaric bupivacaine. Pain levels of the patients were determined by visual analogue scale (VAS) at 24 hours postoperatively and additional analgesic needs were determined. Morphine-related side effects such as nausea-vomiting, pruritus and respiratory depression were evaluated.

Results:

In the postoperative period, VAS scores and additional analgesic needs were found to be significantly lower in the morphine-administered groups compared to the control group. There was no significant difference between Groups II and III in terms of these parameters. Itching and nausea-vomiting were found to be significantly higher in Group III compared to Group II.

Conclusion:

We found that intrathecal 50 μg morphine dose had the same analgesic efficacy as the 100 μg dose for cesarean section operations. We think that 50 μg intrathecal morphine dose is an effective analgesic dose for pain control after cesarean section, due to the lower incidence of postoperative side effects.

Keywords: Caesarean, Intrathecal Morphine, Postoperative Analgesia