Comparison of standing stability with different doses in epidural fentanyl among post-cesarean delivery women: a prospective trial

Efficacy and safety of different doses of epidural morphine coadministered with low-concentration ropivacaine after cesarean section: A retrospective cohort study

“…Adding epidural opioids including morphine following CS has been used clinically in recent decades with excellent analgesic effects, but it has bothersome side effects, such as pruritus, PONV, urinary retention, which are difficult to prevent, and gradually leading to the dissatisfaction of the parturients ( Sultan et al, 2016 ; Payne et al, 2021 ). Moreover, many studies reported that these side effects were dose-dependent and higher dose of epidural opioids were often associated with more frequent potential adverse events ( Otao et al, 2021 ; Oshima and Aoyama, 2022 ). However, another study demonstrated that adverse effects were comparable in different doses of epidural hydromorphone coadministered with ropivacaine after CS ( Yang et al, 2019 ).…”

“…Therefore, some reports have indicated that these side effects may be related to the doses of opioids that are administered and advocated using a modified regimen, such as different combinations of local anesthetics with opioids, to decrease dosage of both opioid and local anesthetics, and thus reduced the incidence of disturbing side effects ( Chen et al, 2011 ; Yang et al, 2019 ; Oshima and Aoyama, 2022 ). However, current regimens that contain even small doses of epidural opioids still cause those complications, which are clinically bothersome to many patients ( Yang et al, 2019 ; Oshima and Aoyama, 2022 ). Therefore, the optimal dose of epidural opioid including morphine which provides potent analgesia but with minimal adverse reactions remains undetermined.…”