Resumen

DONIZ, M. et al. An analysis of the efficacy and safety of epidural morphic chloride administration for postoperative pain following Caesarian section. Rev. Soc. Esp. Dolor [online]. 2011, vol.18, n.1, pp.6-11. ISSN 1134-8046.

Objective: pain control after cesarean section is an important point, as it has tried to implement an analgesic technique that causes minimal side effects while still providing a good quality and duration of it, to have a quick pain relief, good recovery and decreased hospitalization costs. The aim of this study was to analyze the effectiveness and safety of a single bolus administration of two milligrams of morphine epidural catheter as an adjuvant analgesic after cesarean delivery. Matherial and methods: multicenter randomized prospective observational controlled trial along three years in 400 patients, ASA I-II, aged between 18 and 39, for cesarean section with epidural technique. Patients were divided into two groups, one group called GM made up of 200 patients who were given two milligrams of morphine, diluted to 10 cm³ with saline through the epidural catheter, after the completion of the caesarean section and after recovery of sensory and motor block. The other group called GC constituted by the remaining 200 patients and who did not receive epidural morphine. Both groups received the same analgesic protocol with paracetamol and metamizol ruled, and rescue boluses of intravenous morphine in the postoperative recovery unit and ketorolac on the ground. T-Student was used to compare quantitative variables. P < 0.05 was considered significant. Results: the GM had less pain, measured by Visual Analog Scale, at 6, 12, 24 and 48 hours after surgery, than the GC. Supplementary analgesic consumption was similar in both groups. Pruritus was the most common side effect (35% of GM patients) and only exceptionally was annoying. There were no differences between groups in hospital stay or satisfaction. The group with epidural morphine had a better quality of sleep. Discussion: in our study, administration of a single dose of two milligrams of epidural morphine with conventional drugs provides a better post-cesarean analgesia with minimal side effects compared to that obtained when only conventional drugs are administered. According to our results we think that the administration of a bolus of two milligrams of morphine epidural seems a safe and effective technique, so we could join to the analgesic protocol of cesarean.

Palabras clave : Postoperative analgesia; Cesarean; Epidural morphine; Postoperative pain.

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