Patient choice compared with no choice of intrathecal morphine dose for caesarean analgesia: a randomized clinical trial. British journal of anaesthesia Carvalho, B., Mirza, F., Flood, P. 2017; 118 (5): 762-771


The study aimed to determine whether a patient's choice for their intrathecal morphine (ITM) dose reflects their opioid requirements and pain after caesarean delivery and if giving women a choice of ITM dose would reduce opioid use and improve pain scores compared with women who did not have a choice.A total of 120 women undergoing caesarean delivery with spinal anaesthesia were enrolled in this randomized, double-blind study. Patients were randomly assigned to a choice of 100 or 200?µg ITM or no choice. The study involved deception, such that all participants were still randomly assigned 100 or 200?µg ITM regardless of choice. Rescue opioid use over the 48-h study period was the primary outcome measure. Pain at rest and movement and side effect (pruritus, nausea, and vomiting) data were collected 3, 6, 12, 24, 36 and 48?h postoperatively. Data are presented as median [95% confidence interval (CI)].Women who requested the larger ITM dose required more supplemental opioid [median 0.8 (95% CI 0.4-1.3)] mg morphine equivalents at each assessment interval; P ?

View details for DOI 10.1093/bja/aex039

View details for PubMedID 28486595