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- W1979843054 abstract "To the Editor: Marcus et al. (1) suggest that postoperative pain relief is better in patients undergoing postpartum tubal ligation when epidural morphine is administered, as also suggested by Campbell et al. (2). There are several drawbacks to the use of epidural morphine in these patients. Most significantly, epidural morphine is associated with delayed respiratory depression, which may appear up to 24 h after administration. With increasing pressure on hospitals to limit the duration of stay of patients, postpartum patients undergoing tubal ligation the day after delivery are commonly discharged on the same day as the surgery. Such patients should not receive epidural morphine, as they will not be adequately monitored for ventilatory depression. There might be a case for epidural morphine if there were no acceptable alternatives and if all such patients remained in hospital for 24 h after their procedure. However, there are numerous alternatives, including infiltration by the obstetricians with local anesthetic, IV agents such as ketorolac and short-acting opioids, and traditional oral analgesics. More than 75% of such procedures worldwide are done using local anesthesia alone (3). In our view, epidural morphine may be excessive for a procedure that produces only modest postoperative pain of short duration (4). Philip J. Balestrieri, MA, MD Paul H. Ting, MD Randal S. Blank, MD, PhD Obstetric Anesthesia Department of Anesthesiology University of Virginia [email protected]du" @default.
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- W1979843054 date "2006-04-01" @default.
- W1979843054 modified "2023-09-26" @default.
- W1979843054 title "Efficacy of Postoperative Epidural Morphine for Postpartum Tubal Ligation" @default.
- W1979843054 cites W127872952 @default.
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- W1979843054 doi "https://doi.org/10.1213/01.ane.0000199184.14710.f9" @default.
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