Impact of intrathecal morphine on the tolerance of early feeding after cesarean section

Annales Françaises D'anesthèsie Et De Rèanimation
A Tshibangu-NL Hirsoux

Abstract

Early feeding is well tolerated in patients undergoing caesarean section under general or regional anaesthesia. Intrathecal morphine is effective for postoperative analgesia but can induce nausea and vomiting which may hamper feeding. This study assessed prospectively the effects of intrathecal morphine on early feeding in patients undergoing caesarean section. After ethical committee approval, 66 consenting women scheduled for caesarean section were randomized to receive intrathecal morphine 0.1 mg (group M, n=32) or not ("control group", group C, n=34) at the time of intrathecal anaesthesia performed with a 3 ml mixture containing 8.6 mg bupivacaine, 64 microg clonidine and 4.3 microg sufentanil. Standard antiemetic prophylaxis (5 mg dexamethasone + 2 mg tropisetron) was administered intravenously in all patients after umbilical cord clamping. Standardized multimodal analgesia was initiated postoperatively with 1 g of paracetamol and 30 mg of ketorolac given every 6 hours. Analgesia was evaluated by a numeric rating scale (NRS) at 4 hours intervals and 10 mg of oral morphine was administered if the NRS score exceeded 3. All patients received a protein enriched solution, 8 hours after caesarean section and were allowed to eat ...Continue Reading

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Citations

Sep 14, 2012·The Cochrane Database of Systematic Reviews·James D GriffithsJane Thomas

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