Diamorphine analgesia after Caesarean section

In a randomised double‐blind study, the efficacy, duration of action and side effects of five diamorphine analgesia regimens following Caesarean section are described. The time to next analgesia was shorter in the 5 mg intramuscular group (3.53 hours) than in any of the four epidural groups: 5 mg (5.7 hours, p = 0.007), 2.5 mg (4.76 hours, p = 0.103), 5 mg with adrenaline 1/200 000 (7.2 hours, p = 0.001) and 2.5 mg with adrenaline 1/200 000 (6.05 hours, p = 0.007). Multiple regression analysis showed that the addition of adrenaline significantly increased the duration of action of epidural diamorphine (p < 0.05). The 5 mg dose with adrenaline showed no advantage when compared with 2.5 mg with adrenaline (p = 0.16). No serious side effects were reported in any group.

[1]  F. Reynolds,et al.  Lumbar epidural diamorphine following thoracic surgery , 1991, Anaesthesia.

[2]  G. Sharwood-Smith,et al.  Profound respiratory depression after extradural fentanyl. , 1990, British journal of anaesthesia.

[3]  F. Reynolds.  Epidural analgesia in obstetrics. , 1989, BMJ.

[4]  M. Morgan.  The rational use of intrathecal and extradural opioids. , 1989, British journal of anaesthesia.

[5]  B. Ong,et al.  Anesthesia for Cesarean Section—Effects on Neonates , 1989, Anesthesia and analgesia.

[6]  I. Grant,et al.  EFFECT OF THE ADDITION OF ADRENALINE TO EXTRADURAL DIAMORPHINE ANALGESIA AFTER CAESAREAN SECTION , 1988 .

[7]  M. Avram,et al.  Epidural hydromorphone: a double-blind comparison with intramuscular hydromorphone for postcesarean section analgesia. , 1987, Anesthesiology.

[8]  I. Grant,et al.  Double-blind comparison of the efficacy of extradural diamorphine, extradural phenoperidine and i.m. diamorphine following caesarean section. , 1987, British journal of anaesthesia.

[9]  R. Moore,et al.  Epinephrine Reduces Systemic Absorption of Extradural Diacetylmorphine , 1986, Anesthesia and analgesia.

[10]  H. McQuay,et al.  Spinal fluid kinetics of morphine and heroin , 1984, Clinical pharmacology and therapeutics.

[11]  W. Chambers,et al.  Extradural morphine for the relief of pain following caesarean section. , 1983, British journal of anaesthesia.

[12]  W. Woods,et al.  The Role of Epidural Morphine in the Postcesarean Patient: Efficacy and Effects on Bonding , 1983, Anesthesiology.

[13]  F. Reynolds,et al.  Epidural diamorphine and fentanyl for postoperative pain , 1981, Anaesthesia.

[14]  F. Magora,et al.  EPIDURAL MORPHINE IN TREATMENT OF PAIN , 1979, The Lancet.

[15]  I. Grant,et al.  Effect of the addition of adrenaline to extradural diamorphine analgesia after caesarean section. , 1988, British journal of anaesthesia.