Purpose: To test the hypothesis that O. I mg intrathecal morphine plus NSAIDs provides satisfactory analgesia post-Cesarean section with fewer side effects than 0.25 mg intrathecal morphine. Methods: Sixty women, scheduled for elective Cesarean section under spinal anesthesia, were randomized to receive either 0. I mg or 0.25 mg intrathecal morphine combined with hyperbaric bupivacaine 0.75% and 20/lg fentanyl. All patients received a I O0 mg indomethacin suppository at the end of surgery and 500 mg naproxen po b.i.d, was started the evening of surgery and continued until discharge. A blinded researcher recorded the pain, pruritus, and nausea scores, the time to first request for additional analgesics, a visual analogue scale (VAS) satisfaction score, and the use of additional opioids, antipruritics, and/or antiemetics. Results: Of the 60 patients enrolled, two were not included in the data analysis because of protocol violations leaving 30 patients in the 0. I mg group and 28 in the 0.25 mg group. There were no differences in the VAS pain scores or the number of women requesting an opioid other than codeine between the two groups. The VAS pruritus scores in the 0. I mg group were lower throughout the 24 hr (P < 0.001 ). Fewer women in the 0. I mg group (4/30 vs 12/28) requested nalbuphine'to treat itching (P = 0.018). Nausea scores were lower in the 0. I mg group (P < 0.00 I). Conclusion: The use of 0. I mg intrathecal morphine plus NSAIDs provides analgesia of similar quality to 0.25 mg but with fewer undesirable side effects following Cesarean section.Objectis : V&ifier I'hypoth~se qui veut que O, I mg de morphine intrath6cale combin~e ~ des AINS foumissent une analg&ie satisfaisante ~ la suite d'une c&arienne et moins d'effets secondaires que 0,25 mg de morphine intrath&ale. M~thode 9 Soixante femmes, admises pour une c&arienne planiti& sous rachianesth&ie et r~parties au hasard ont regu 0, I. mg ou 0,25 mg de morphine intrath&ale combin& ~ de la bupivacaine hyperbare 0,75 % et ~ 20 /~g de fentanyl. Toutes ont regu un suppositoire de 100 mg d'indom6thacine ~ la fin de I'op&ation et 500 mg de naproxEne po b.i.d. ~ partir du premier soir jusqu'au jour du d~part. Un anesth6.siologiste impartial a enregistr~ les scores de douleurs, de prurit et de naus~es, le temps avant la premiere demande d'analg&iques suppl~men-taires, le degrE de satisfaction ~ I'&helle visuelle analogue (EVA) et I'usage d'opidides, d'antiprurigineux et/ou d'anti6m&iques additionnels. l~.sultats : Des 60 patientes recrut&s, deux front pu participer ~ la cueillette de donn~es ~ cause de violations au protocole de recherche; il est restE 30 patientes clans le groupe de 0, I mg et 28 dans celui de 0,25 mg. II n'y a pas eu de diff&ence intergroupe pour les scores ~ I'EVA ou le nombre de femmes qui ant demand~ un opio'l'de autre que la cod6ine. Le degr6 de prurit fourni par I'EVA a 6t~ plus bas dans le groupe de 0, I mg pendant 24 h (P < 0,001). Moins de femmes du groupe de O, I mg (4/30 vs 12/28) ont demand6 de la nalbuphine contre le prurit (P ...
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