Patients presenting for normal spontaneous vaginal delivery who have a neuraxial anesthestic will be randomized to receive preservative free morphine or saline placebo after delivery.
After obtaining consent, women presenting to the labor floor at Mount Sinai Hospital will be randomized into two groups, intervention and placebo. Baseline demographic data and surveys in regards to postpartum depression, anxiety, breastfeed willingness and pain scores will be obtained. After delivery of the baby patients will either receive 2mg preservative free morphine or saline via the epidural catheter prior to its removal. The study team will then record pain and recovery scores, as well as follow up screens to the aforementioned endpoints. The study will end at the 6 week postpartum visit with the patient's obstetrician.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
160
After delivery of the baby patients will receive via the epidural catheter prior to its removal.
After delivery of the baby patients will receive via the epidural catheter prior to its removal.
Mount Sinai Hospital
New York, New York, United States
Opioid Consumption in MME
Quantity of opioid in morphine milligram equivalents (MME) used within 24 hours of delivery. The conversions from opioids to MME were as follows: 2 mg oral hydromorphone as 8 MME, 5 mg oxycodone 7.5 MME. To convert the PO hydromorphone to MME, IV hydromorphone was converted to morphine with a 4:1 ratio to convert to morphine followed by a 1:3 ratio to convert IV to PO.
Time frame: within 24 hours of delivery
Pain Score
Pain Score: Likert full scale 0-10, with higher score indicating more pain
Time frame: at 24 hours
Obstetric Quality of Recovery Score (OBSQ10)
OBSQ10 total score 0-100, with higher score indicating better health status
Time frame: 24 hours
Number of Participants With Edinburgh Postnatal Depression Scale (EPDS) >10
Number of Participants with positive EPDS screen in the 6-week post-delivery EPDS defined as a score higher than 10. The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item instrument to assess postpartum depression, with total score from 0-30. Higher score indicates more depressed symptoms.
Time frame: up to 6 weeks
Number of Participants With Exclusive Breast Feeding
Participants will respond yes/no as to their breast feeding success and continuation exclusively.
Time frame: 1 week
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