Efficacy of dexmedetomidine in combination with morphine for pain management in patients with cesarean section

Abstract

<p><strong>Background & Objectives:</strong> Intraspinal morphine shows a high analgesic efficacy but high incidence of adverse events and dexmedetomidine (Dex) improves anesthesic actions and anesthesia-related adverse reactions. This study compares the efficacy and safety of intravenous Dex and epidural morphine administration versus morphine alone for post-caesarean analgesia.</p>
 <p><strong>Methods:</strong> Eighty women receiving caesarean sections were assigned to the Dex-morphine combination group and morphine group. Subjects in both groups were given morphine after caesarean sections. After delivery, women in the combination group were given Dex, while subjects in the morphine group were given physiological saline. Serum cortisol, renin and potassium was measured before anesthesia, immediately and 24 hours after caesarean sections, and the visual analog scale (VAS) and observer’s assessment of alertness/sedation scale (OAA/S) scores were assessed 4, 8, 12 and 24 hours after caesarean sections. In addition, post-operative adverse events were recorded, and intraoperative urine volume and urine 24-hour volume after caesarean sections were measured.</p>
 <p><strong>Results: </strong>Lower cortisol and renin was measured in the combination group than in the morphine group immediately after caesarean sections (<em>P</em> < 0.05), while no significant differences were found in serum potassium between two groups at each time point (<em>P</em> > 0.05). Lower VAS scores were measured in the combination group than in the morphine group 12 and 24 hours after caesarean sections (<em>P</em> < 0.05); however, no significant differences were seen in the OAA/S score (<em>P</em> > 0.05). Lower incidence of shivering and nausea/vomiting was seen in the combination group than in the morphine group after caesarean sections, and greater intraoperative urine volume and urine volume within 24 hours after caesarean sections were measured in the combination group than in the morphine group (<em>P</em> < 0.05).</p>
 <p><strong>Conclusion:</strong> Dex-morphine combinations achieve a higher efficacy and lower incidence of adverse events than morphine alone for post-caesarean analgesia.</p>