Prospective Study of Pain After Spinal Morphine for Cesarean Section and Factors Involved in Moderate to Severe Pain
Study Details
Study Description
Brief Summary
Spinal block with intrathecal morphine is a popular anesthetic technique in cesarean delivery. This technique brings about good maternal and neonatal outcomes as well as provides good postoperative pain control. Systematic review showed intrathecal morphine produced long period of pain control up to 27 hours. However, some patients still experienced moderate to severe pain which defined as postoperative pain score >,= 4. From our institute survey, there were more than 50 percents of patients undergoing cesarean delivery receiving spinal block with intrathecal morphine experienced moderate to severe pain in the first 24 hours.
The aim of the study is to determine the actual incidence and associated factors of patients whom experienced moderate to severe pain after spinal anesthesia with intrathecal morphine 200 mcg in cesarean delivery.
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Detailed Description
Spinal block with intrathecal morphine is a popular anesthetic technique in cesarean delivery. This technique brings about good maternal and neonatal outcomes as well as provides good postoperative pain control. Systematic review showed intrathecal morphine produced long period of pain control up to 27 hours. However, some patients still experienced moderate to severe pain which defined as postoperative pain score >,= 4. From our institute survey, there were more than 50 percents of patients undergoing cesarean delivery receiving spinal block with intrathecal morphine experienced moderate to severe pain in the first 24 hours. Failure in achieve adequate pain control results in poor maternal satisfaction, effect breast feeding and may lead to chronic wound pain.
The aim of the study is to determine the actual incidence of patients whom experienced moderate to severe pain after spinal anesthesia with intrathecal morphine 200 mcg in cesarean delivery. Also, factors that may involved moderate to severe postoperative pain will be analyzed and reported.
Study Design
Outcome Measures
Primary Outcome Measures
- Incidence of moderate to severe pain [The first 24 hours postoperatively]
Incidence of moderate to severe pain, pain score >,= 4
Secondary Outcome Measures
- Factors associated with moderate to severe pain [The first 24 hours postoperatively]
Factors associated with moderate to severe pain, pain score >,= 4
- Incidence of moderate to severe pain in the 2nd postoperative day [Form 24 hours to 48 hours postoperatively]
Incidence of moderate to severe pain (pain score >,= 4) in the 2nd postoperative day
Eligibility Criteria
Criteria
Inclusion Criteria:
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Age > 18 years
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Elective cesarean section
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Patient accept spinal anesthesia
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ASA classification I-II
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Understand numerical rating scale for pain score
Exclusion Criteria:
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Not understand Thai
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Contraindicated in spinal anesthesia with intrathecal morphine
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Complicated pregnancy that general anesthesia may required for cesarean delivery
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Anesthesiology department, Siriraj hospital, Mahidol University | Bangkok | Thailand | 10700 |
Sponsors and Collaborators
- Mahidol University
Investigators
- Principal Investigator: Patchareya Nivatpumin, M.D., Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
Study Documents (Full-Text)
None provided.More Information
Publications
- Dahl JB, Jeppesen IS, Jørgensen H, Wetterslev J, Møiniche S. Intraoperative and postoperative analgesic efficacy and adverse effects of intrathecal opioids in patients undergoing cesarean section with spinal anesthesia: a qualitative and quantitative systematic review of randomized controlled trials. Anesthesiology. 1999 Dec;91(6):1919-27. Review.
- Deussen AR, Ashwood P, Martis R. Analgesia for relief of pain due to uterine cramping/involution after birth. Cochrane Database Syst Rev. 2011 May 11;(5):CD004908. doi: 10.1002/14651858.CD004908.pub2. Review. Update in: Cochrane Database Syst Rev. 2020 Oct 20;10:CD004908.
- Ip HY, Abrishami A, Peng PW, Wong J, Chung F. Predictors of postoperative pain and analgesic consumption: a qualitative systematic review. Anesthesiology. 2009 Sep;111(3):657-77. doi: 10.1097/ALN.0b013e3181aae87a. Review.
- Lavand'homme P. Postcesarean analgesia: effective strategies and association with chronic pain. Curr Opin Anaesthesiol. 2006 Jun;19(3):244-8. Review.
- Zeng AM, Nami NF, Wu CL, Murphy JD. The Analgesic Efficacy of Nonsteroidal Anti-inflammatory Agents (NSAIDs) in Patients Undergoing Cesarean Deliveries: A Meta-Analysis. Reg Anesth Pain Med. 2016 Nov/Dec;41(6):763-772.
- 164/2560(EC2)