Enhanced recovery after caesarean section: an intrathecal morphine dosing study
Authors' conclusion
All doses of ITM provide effective analgesia with 100 mcg dosing providing the best trade-off between analgesic efficacy and side effect profile.
Study context
- Population
- ASA 2 females over 18 years having repeat elective caesarean sections
- Participants
- 574 participants
- Exposure
- Intrathecal morphine 125 mcg or 100 mcg vs 150 mcg within an enhanced recovery protocol
- 150 mcgn = 190reference
- 125 mcgn = 191
- 100 mcgn = 193
- Outcome
- Total oral MME (mg), proportion of opioid-free patients, and frequency of ITM-related side-effects
- Follow-up
- 24 and 48 h
Main finding
As reported in the abstract
Opioid consumption and opioid-free patients
- Median opioid consumption at 24 h: 150 mcg
- 10 mg
- Median opioid consumption at 24 h: 125 mcg and 100 mcg
- 20 mg
- Median opioid consumption at 48 h: 150 mcg
- 30 mg
- Median opioid consumption at 48 h: 125 mcg and 100 mcg
- 45 mg
- Opioid-free at 24 h: 150 mcg
- 41%
- Opioid-free at 24 h: 125 mcg
- 31%
- Opioid-free at 24 h: 100 mcg
- 28%
- Opioid-free at 48 h: 150 mcg
- 24%
- Opioid-free at 48 h: 125 mcg (37.5% reduction)
- 15%
- Opioid-free at 48 h: 100 mcg (45.8% reduction)
- 13%
Observational data: associations, not effects.
Secondary outcomes
| Outcome | 150 mcg | 125 mcg | 100 mcg | Median difference (h) |
|---|---|---|---|---|
| Duration of analgesia | median 21 h | 13 h | 12 h | |
| LOSNo difference between doses | 1.1 |
Pain scores · 24 h
- No significant difference in pain scores between doses
FAS scores · 24 h
- Trend towards functional limitation with 125 mcg and 100 mcg vs 150 mcg; no difference between 125 mcg and 100 mcg
Safety
Pruritus · dose-dependent increase in side-effects
Nausea and vomiting
Original publication
Enhanced recovery after caesarean section: an intrathecal morphine dosing study. Perioper Med (Lond). Published 14 October 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →