Epidural Morphine for Analgesia After Traumatic Vaginal Delivery

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

Overview

This pilot study intends to establish the efficacy of 2 different doses of epidural morphine for pain management after perineal trauma when using multimodal analgesia as well as the feasibility of conducting a larger randomized clinical trial. Women with traumatic vaginal delivery will be randomized into 3 groups with 10 patients each and receive 2.5 mg epidural morphine, 1.25 mg epidural morphine, or epidural saline. The primary outcome is total opioid consumption for breakthrough pain in the first 24 hours.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Conditions

Traumatic Vaginal Delivery

Interventions

MorphineDRUG

Comparison of different dosages of drug

PlaceboDRUG

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 40 Years

Medical Language ↔ Plain English

Inclusion Criteria: * The patient is 18 years or older * The patient is ASA 1-3 * Gestation 37-42 weeks * The patient had a vaginal delivery * The patient received epidural analgesia for labor and delivery Exclusion Criteria: * The patient has refused to participate * The patient cannot give informed consent * The investigator has significant concerns for maternal or neonatal welfare * The patient has a history of allergy to opioids * The patient has a history of chronic opioid consumption * The patient has a history of narcotic abuse * The patient has an allergy to local anesthetics * The patient has a contraindication to taking NSAIDs or acetaminophen * The patient received combined spinal-epidural analgesia * The patient has a history of chronic pain

Outcomes

Primary Outcomes

Total breakthrough opioid consumption

Time frame: First 24 hours after delivery