RESUMO
The analgesic properties and motor effect of epidural 0.25% bupivacaine (8 mL) were compared with those of epidural morphine (2 mg in 10 mL saline) followed by 8 mL of 0.25% bupivacaine. The study was performed on two groups of parturients (30 in each group) in active labor. Pain relief in the morphine-bupivacaine group lasted for a mean of 131.1 minutes (SD +/- 49.8) as opposed to the plain bupivacaine group -57 minutes (SD +/- 15.28). Satisfaction from analgesia in the morphine-bupivacaine group was higher as well. Motor involvement was not seen in either group. Perineal pain relief in the postpartum period lasted for a mean of 16 hours and 40 minutes in the morphine-bupivacaine group. It was concluded that the concomitant use of epidural morphine augmented the analgesic effect of 0.25% bupivacaine without motor effect.
Assuntos
Analgesia , Bupivacaína/administração & dosagem , Trabalho de Parto , Morfina/administração & dosagem , Dor/prevenção & controle , Adolescente , Adulto , Parto Obstétrico/métodos , Sinergismo Farmacológico , Espaço Epidural , Feminino , Humanos , Bloqueio Nervoso , GravidezRESUMO
A prospective study was performed on the effect of epidural morphine (2 mg in 10 ml of saline) in three groups of patients: (1) following gynecological operations, 60; (2) following cesarean section, 120; (3) patients in active labor, 30. Pain relief in the first group was uniformly and almost invariably complete for up to 24 hours. In the second group spasmodic visceral pain was felt after about 10 hours, relieved by light analgesics. The wound was not painful. In the third group only hypoalgesia was obtained during labor, but if an episiotomy was done, the pain in the perineum was relieved. Few side effects were observed: urinary retention, vomiting, and non-segmental itching. Neither motor nor sympathetic block were noted. The somatic effect of epidural morphine was reliable and uniform, whereas visceral pain was poorly affected. The side effects cause relatively little disturbance at the dose used.