Articles  |   January 2015
SEE Question
Article Information
Obstetric Anesthesia / Pain Medicine / Articles
Articles   |   January 2015
SEE Question
ASA Monitor 01 2015, Vol.79, 36-37.
ASA Monitor 01 2015, Vol.79, 36-37.
A woman is receiving epidural anesthesia with 2 percent lidocaine for cesarean delivery after a failed trial of labor. She reports that with her previous cesarean delivery, she experienced severe pruritus after receiving epidural morphine for postoperative analgesia. In an effort to minimize this side effect, you decide to use multimodal analgesia that includes ketorolac, acetaminophen, and 1.5 mg epidural morphine instead of the 3 mg morphine dose that is part of your usual post-cesarean regimen. Based on a recent prospective, randomized study, which of the following will most likely be an effect of decreasing the morphine dose?
Epidural morphine is frequently used to provide postoperative analgesia after cesarean delivery. Side effects such as pruritus, nausea, and vomiting are common. Although rare, respiratory depression is a serious adverse effect that can also occur with neuraxial opioids. Several studies have attempted to determine the ideal epidural morphine dose for postcesarean analgesia that provides adequate pain relief while minimizing side effects. However, the design for many of these studies did not include a multimodal analgesic regimen, which is now preferred by anesthesiologists. A recent randomized, double-blinded noninferiority study compared the use of 1.5 mg versus 3 mg epidural morphine for postcesarean pain relief when used as part of a multimodal approach that also included ketorolac and acetaminophen.
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