The effects of continuous intravenous naloxone on epidural morphine analgesia

Forty–Jive patients undergoing Caesarean section under epidural anaesthesia with bupivacaine were randomly allocated to three groups. Group I received 4 mg of epidural morphine immediately postoperatively and 2 mg naloxone by intravenous infusion for 12 hours postoperatively; group 2 was treated as group I but without naloxone infusion: group 3 received 10 mg morphine intramuscularly and 20 ml epidural saline after delivery of the baby. Epidural morphine 4 mg produced better postoperative analgesia than 10 mg of morphine intramuscularly (p < 0·001) and the intravenous infusion of naloxone did not ablate the analgesic effects of epidural morphine. The incidence of itching and vomiting was higher in the epidural opioid groups (p < 0.05) and intravenous naloxone, although it reduced the severity of the itching, did not reduce its overall incidence. Respiratory depression was not detected in any of the three groups.

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