Efficacy of intrathecal morphine with epidural ropivacaine infusion for postcesarean analgesia

Patient-Controlled Epidural Levobupivacaine with or without Fentanyl for Post-Cesarean Section Pain Relief

“…Pure local anesthetics are not widely used for routine postoperative epidural analgesia because of the significant rate of insufficient pain relief and unacceptable incidence of motor blockade [7, 8]. However, we have been using pure epidural ropivacaine after C/S, and it offered comparable analgesic efficacy to epidural morphine without delaying the time of first ambulation [9].…”

Randomized study of postcesarean analgesia with intrathecal morphine alone or combined with clonidine

“…Calculation of the sample size was based on previous studies [6,8] and on the ability to detect a minimum difference between groups of 1 cm in pain measured by the VAS during movement. Based on a significance level of 5% and statistical power of 90%, 59 patients were required for each group.…”

“…However, the clinical dose of intrathecal morphine ranges from 25 to 500 μg. Incorrect dosing within this broad range can lead to unsatisfactory pain relief or to an increase in the incidence of side effects [1][2][3][4][5][6][7][8][9][10][11][12]. A study evaluating postoperative analgesia in adults showed that 86% of patients reported moderate/severe pain [13].…”

Post-caesarean analgesia: What is new?

“…[3] A further lower dose of 50 µg with 100 µg ITM was evaluated in two studies and found to be equally efficacious. [45] These results showed that there is no direct relationship between the dose of ITM and the quality of analgesia. Similar results were demonstrated in previous studies by other investigators.…”