Single-dose, sustained-release epidural morphine in the management of postoperative pain after elective Cesarean delivery: Results of a multicenter randomized controlled study ANESTHESIA AND ANALGESIA Carvalho, B., Riley, E., Cohen, S. E., Gambling, D., PALMER, C., Huffnagle, H. J., Polley, L., Muir, H., Segal, S., Lihou, C., Manvelian, G. 2005; 100 (4): 1150-1158


In this multicenter, randomized, controlled study, we compared the analgesic efficacy and safety profile of a new single-dose extended-release epidural morphine (EREM) formulation (DepoDur) with that of epidural morphine sulfate for the management of postoperative pain for up to 48 h after elective cesarean delivery. ASA physical status I or II parturients (n = 75) were anesthetized with a combined spinal/epidural technique. Parturients received intrathecal bupivacaine 12-15 mg and fentanyl 10 mug for spinal anesthesia and a single epidural injection of either 5 mg of standard (conventional preservative-free) morphine or 5, 10, or 15 mg of extended-release morphine after cord clamping for postoperative pain control. Single-dose EREM 10 and 15 mg groups significantly decreased total supplemental opioid medication use and improved functional ability scores for 48 h after surgery compared with those receiving 5 mg of standard morphine. Visual analog scale pain scores at rest and with activity at 24 to 48 h after dosing were significantly better in the 10- and 15-mg single-dose EREM groups versus the standard morphine group. There were no significant differences between the two 5 mg (single-dose EREM and standard morphine) groups. Single-dose EREM was well tolerated, and most adverse events were mild to moderate in severity. Single-dose EREM is a potentially beneficial epidural analgesic for the management of post-cesarean delivery pain and has particular advantages over standard morphine for the period from 24 to 48 h after surgery.

View details for DOI 10.1213/01.ANE.0000149544.58230.FF

View details for Web of Science ID 000227792400040

View details for PubMedID 15781537