A randomized controlled trial of spinal morphine with an enhanced recovery pathway and its effect on duration of analgesia after cesarean delivery
Authors' conclusion
The duration of analgesia using intrathecal morphine with an enhanced recovery pathway was longer with 250 mcg than with lower doses, and side effects were similar. 50 mcg provided inferior pain relief over 24 h.
Study context
- Population
- Healthy women undergoing scheduled cesarean delivery with a standardized postoperative enhanced recovery pathway
- Participants
- 72 women
- Comparison
- 50 mcg vs 150 mcg vs 250 mcg
- Primary endpoint
- Time to request supplemental opioids (duration of analgesia)
Methodological detailsnon-inferiority
- Non-inferiority
Primary result
As reported in the abstract
Duration of analgesia
50 mcg
24.5
median · IQR 3.5–34.4 · h
150 mcg
29.4
IQR 24.5–72 · h
250 mcg
32
IQR 30.5–72 · h
Secondary outcomes
Opioid-free · up to 72 h
Pain scores, supplemental opioids, quality of recovery
- 50 mcg: higher pain scores, more supplemental opioids, lower quality of recovery scores than other doses
- Secondary outcomes similar between 150 mcg and 250 mcg
Safety
Side effects
- Similar among all groups
Original publication
A randomized controlled trial of spinal morphine with an enhanced recovery pathway and its effect on duration of analgesia after cesarean delivery. Anaesth Crit Care Pain Med. Published 18 October 2023. doi:10.
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