The purpose of this study is to determine the ideal dose of spinal morphine for use in Cesarean section. Spinal anesthesia (single injection in the lower back to numb patients from the waist down) is commonly used in Cesarean section to provide numbness and pain relief during the surgery, and adding morphine to the spinal anesthetic provides long lasting pain relief for up to 24 hours after surgery. The ideal dose of spinal morphine, when given with other types of pain medications such as nonsteroidal anti-inflammatories and acetaminophen, has not been determined. In addition, spinal morphine can have side effects such as nausea and itching, so using a lower dose of morphine may decrease these side effects while providing the same amount of postoperative pain relief. Study participants will be divided into two groups. Group 1 will receive the standard dose of spinal morphine (0.1mg) while Group 2 will receive a lower dose of spinal morphine (0.05mg). Both groups will receive the standard dose of spinal bupivacaine (numbing medication) and spinal fentanyl (short acting pain medication). The additional pain medications (IV Toradol and oral acetaminophen) will be given to both groups after surgery. Pain control and morphine side effects will be compared between the two groups in order to determine the best dose of spinal morphine for cesarean section.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
229
Patients will receive the standard of care dose 0.1 mg of intrathecal morphine
Patients will receive 0.05 mg of intrathecal morphine
Medical University of South Carolina
Charleston, South Carolina, United States
Time to First Narcotic Rescue Dose in the First 24 Hours Post-cesarean Delivery.
This is defined as the number of hours until the first rescue dose of medication was given to participants within the first 24-hours post-op.
Time frame: 24 hours
Time to First Ambulation After C-section
This outcome evaluated the amount of time reported in hours after c-section the patient first ambulated.
Time frame: up to 48 hours
Opioid Medication Given During the Participant's Hospital Stay.
This outcome looks at whether or not any opioid medications were given during the participant's hospital stay, reporting the number of subjects who received opioid pain medication during the admission.
Time frame: From the time of the procedure through discharge, up to 48 hours.
Subjective Pain Rating Using Visual Analogue Scales (VAS) Ranging From 0-100.
Subjective pain with ambulation reported by participants using visual analogue scales (VAS) ranging from 0-100 at the 24-hour post-op time point and 48-hour post-op time point. The lower the number, the better the outcome.
Time frame: 24-hours post operatively and 48-hours post operatively
Presence of Opiate Side Effects (Nausea, Vomiting, and Pruritus)
The presence of opiate side effects (nausea, vomiting, and pruritus) was evaluated from 0-24 hours post-op.
Time frame: 24 hours post operavtively
Overall Patient Satisfaction With Pain Control
Patients were asked to mark their satisfaction with pain control using a Visual Analog Scale (VAS) from 0-100. The higher the number, the more satisfied they were with the post-op pain control
Time frame: 48 hours post-op
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