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Patient -controlled epidural ropivacaine as a post-Cesarean analgesia: a comparison with epidural morphine.
Taiwan J Obstet Gynecol. 2011 Dec; 50(4):441-6.TJ

Abstract

OBJECTIVE

Conventional, intermittent, epidural morphine is widely applied as a post-Cesarean delivery analgesia. We compared the analgesic efficacy, motor weakness, and side effects of administering a patient-controlled epidural analgesia (PCEA) of pure ropivacaine versus the intermittent administration of epidural morphine after Cesarean delivery.

MATERIALS AND METHODS

This randomized, double-blind study included 120 full-term parturients who underwent elective Cesarean delivery and received either PCEA with pure ropivacaine or an intermittent bolus epidural of 2 mg/10 mL morphine in normal saline twice per day. The efficacy of pain relief, post-Cesarean side effects, motor blockades, time to first ambulation, and global satisfaction scores were evaluated.

RESULTS

Pain scores were recorded at the four evaluation times (2, 12, 24, and 48 hours post-Cesarean delivery), and the time to first ambulation did not statistically differ between the two groups. Patients in the ropivacaine group experienced more motor weakness at 2 and 12 hours, fewer side effects, and higher global satisfaction scores than those in the morphine group (p < 0.05).

CONCLUSION

The analgesic efficacy after cesarean delivery was almost equivalent between two groups. PCEA with pure ropivacaine induced significant motor blockade during the first 12 hours, but without delaying the time to first ambulation. Patients in the ropivacaine group reported higher patient satisfaction scores due to the significant reduction of annoying side effects, such as pruritus, nausea, vomiting, and urinary retention.

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Authors+Show Affiliations

Chen LK
Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Lin PL
No affiliation info available
Lin CJ
No affiliation info available
Huang CH
No affiliation info available
Liu WC
No affiliation info available
Fan SZ
No affiliation info available
Wang MH
No affiliation info available

MeSH

AdultAmidesAnalgesia, Patient-ControlledAnalgesics, OpioidAnesthetics, LocalCesarean SectionDouble-Blind MethodDrug Administration ScheduleFemaleHumansInjections, EpiduralMorphinePain MeasurementPain, PostoperativePatient SatisfactionPregnancyProspective StudiesRecovery of FunctionRopivacaineTreatment Outcome

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

22212315

Citation

Chen, Li-Kuei, et al. "Patient -controlled Epidural Ropivacaine as a post-Cesarean Analgesia: a Comparison With Epidural Morphine." Taiwanese Journal of Obstetrics & Gynecology, vol. 50, no. 4, 2011, pp. 441-6.
Chen LK, Lin PL, Lin CJ, et al. Patient -controlled epidural ropivacaine as a post-Cesarean analgesia: a comparison with epidural morphine. Taiwan J Obstet Gynecol. 2011;50(4):441-6.
Chen, L. K., Lin, P. L., Lin, C. J., Huang, C. H., Liu, W. C., Fan, S. Z., & Wang, M. H. (2011). Patient -controlled epidural ropivacaine as a post-Cesarean analgesia: a comparison with epidural morphine. Taiwanese Journal of Obstetrics & Gynecology, 50(4), 441-6. https://doi.org/10.1016/j.tjog.2011.10.008
Chen LK, et al. Patient -controlled Epidural Ropivacaine as a post-Cesarean Analgesia: a Comparison With Epidural Morphine. Taiwan J Obstet Gynecol. 2011;50(4):441-6. PubMed PMID: 22212315.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patient -controlled epidural ropivacaine as a post-Cesarean analgesia: a comparison with epidural morphine. AU - Chen,Li-Kuei, AU - Lin,Pei-Lin, AU - Lin,Chen-Jung, AU - Huang,Chi-Hsiang, AU - Liu,Wan-Chi, AU - Fan,Shou-Zen, AU - Wang,Mao-Hsien, PY - 2010/12/28/accepted PY - 2012/1/4/entrez PY - 2012/1/4/pubmed PY - 2012/10/2/medline SP - 441 EP - 6 JF - Taiwanese journal of obstetrics & gynecology JO - Taiwan J Obstet Gynecol VL - 50 IS - 4 N2 - OBJECTIVE: Conventional, intermittent, epidural morphine is widely applied as a post-Cesarean delivery analgesia. We compared the analgesic efficacy, motor weakness, and side effects of administering a patient-controlled epidural analgesia (PCEA) of pure ropivacaine versus the intermittent administration of epidural morphine after Cesarean delivery. MATERIALS AND METHODS: This randomized, double-blind study included 120 full-term parturients who underwent elective Cesarean delivery and received either PCEA with pure ropivacaine or an intermittent bolus epidural of 2 mg/10 mL morphine in normal saline twice per day. The efficacy of pain relief, post-Cesarean side effects, motor blockades, time to first ambulation, and global satisfaction scores were evaluated. RESULTS: Pain scores were recorded at the four evaluation times (2, 12, 24, and 48 hours post-Cesarean delivery), and the time to first ambulation did not statistically differ between the two groups. Patients in the ropivacaine group experienced more motor weakness at 2 and 12 hours, fewer side effects, and higher global satisfaction scores than those in the morphine group (p < 0.05). CONCLUSION: The analgesic efficacy after cesarean delivery was almost equivalent between two groups. PCEA with pure ropivacaine induced significant motor blockade during the first 12 hours, but without delaying the time to first ambulation. Patients in the ropivacaine group reported higher patient satisfaction scores due to the significant reduction of annoying side effects, such as pruritus, nausea, vomiting, and urinary retention. SN - 1875-6263 UR - https://www.unboundmedicine.com/medline/citation/22212315/Patient__controlled_epidural_ropivacaine_as_a_post_Cesarean_analgesia:_a_comparison_with_epidural_morphine_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1028-4559(11)00167-7 DB - PRIME DP - Unbound Medicine ER -