The investigators believe that pain management following a vaginal delivery can be improved. Many women receive epidural medication during labor and delivery, and the investigators felt that using the epidural following delivery might improve the first day pain. This study is to determine whether a single dose of epidural morphine given to mothers after a vaginal delivery will reduce the perineal pain in the postpartum period.
Vaginal deliveries comprise 80-85% of all deliveries. Although this is felt to be natural and safe, this route can be associated with significant perineal trauma and subsequent postpartum perineal pain. The degree of perineal trauma varies from the minimum of vaginal stretching and distension associated with labor, to episiotomy and significant perineal tears. In spite of the differences in the degree of injury following vaginal delivery, postpartum pain therapy is poorly organized and at best consists of simple analgesics and anti-inflammatory drugs. The purpose of this study is to determine if a single dose of epidural-administered morphine offers additional advantage to an organized program for the management of immediate postpartum perineal pain following vaginal delivery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
228
One time dose of preservative-free epidural morphine 2.5 mg given within one hour following vaginal delivery
5 ml of epidural preservative-free saline given within one hour following vaginal delivery
Mount Sinai Hospital
Toronto, Ontario, Canada
The Number of Women Who Received Systemic Narcotic Analgesics in the First 24 Hours Postpartum
Time frame: 24 hours postpartum
Time to First Request for Analgesia
All participants requested analgesia at least once during their hospitalization
Time frame: Hours
Maternal Visual Analogue Scale (VAS) Score at Time of Request for First Additional Analgesic
Participants were asked to indicate on a 10 cm line the point at which their perineal pain scored between one end anchored with "no pain in my bottom" to the other end anchored with "the worst pain in my bottom that I can imagine"
Time frame: by 24 hours postpartum
Maternal Satisfaction With Perineal Pain Management
5 point Likert scale asking for agreement with the statement "I was satisfied with my pain relief for the pain in my bottom during the first day after delivery". Scale ranged from strongly disagree to strongly agree.
Time frame: at 24 hours postpartum
Side Effects
Number of participants with pruritus, nausea and vomiting, urinary retention, drowsiness in the first 24 hours postpartum
Time frame: at 24 hours postpartum
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