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• W2009310504 abstract "S374 Introduction: Combined spinal-epidural (CSE) anesthesia with intrathecal (IT) fentanyl and low-dose bupivacaine produces analgesia lasting 90 min within 1-2 min [1]. Intrathecal morphine [ITM; onset, 60 min [2], duration 2-3 hrs [3]] produces dose-related side effects such as pruritus, nausea, and vomiting [4]. This study assessed the duration of pain relief and side effects of three doses of ITM with fentanyl and low-dose bupivacaine in CSE anesthesia. Methods: 55 ASA class 1 and 2 parturients in active labor gave informed consent to this double-blind, IRB-approved study. Parturients were randomized to receive ITM 100[micro sign]g (Group A), 150[micro sign]g (Group B), or 200[micro sign]g (Group C). All three groups received fentanyl 25 [micro sign]g and isobaric bupivacaine 2.5mg with ITM. After a fluid bolus with lactated Ringer's solution, CSE was performed with 27-ga Whitacre needle and the drugs were injected intrathecally. Hemodynamics and pain scores (10 cm visual analog scale [VAS]) were assessed before and 1, 5, 10, 15 and 20 min after block, and continuous fetal heart rate was monitored. Side effects (respiratory depression, defined as 85% SpO2 or respiratory rate < 10 breaths/min; pruritus, nausea, and vomiting evaluated by VAS) were measured after block and 12-24 hr later. When additional pain relief was requested, the epidural catheter was activated. Statistical analysis was done using Fisher's exact test and chi-square test. Results: Seven parturients were excluded from data analysis because no CSF was aspirated through the spinal needle. There was no difference between the three groups with respect to demographic data, initial cervical dilatation, Apgar scores, cord blood gases, or VAS pain scores. Duration of analgesia was 121 +/- 42.74 min (Group A), 132 +/- 45.54 min (Group B), and 156 +/- 107.94 min (Group C). No respiratory depression occurred in any of the patients. Complications are shown in Table 1.Table 1: ComplicationsSBP [down arrow] Rx with ephedrine; pruritus Rx with diphenhydramine; Nausea and vomiting Rx with promethazine Discussion: Incidence of side effects requiring treatment was greater in those receiving large doses of ITM. The duration of action of 100[micro sign]g of ITM may be similar to that of IT fentanyl and bupivacaine combination [5]. In this ongoing study inferences cannot yet be made about the duration of action of ITM at varying doses." @default.
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• W2009310504 date "1998-02-01" @default.
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• W2009310504 title "EFFECTIVE DOSE OF INTRATHECAL MORPHINE WITH FENTANYL AND LOW-DOSE BUPIVACAINE IN EARLY LABOR" @default.
• W2009310504 doi "https://doi.org/10.1097/00000539-199802001-00372" @default.
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