Morphine Spinal Anesthesia for Cesarean Section at the Regional Hospital of Saint Louis in Senegal: About 119 Cases Collected

Abstract

Introduction: Post-operative pain management has been the subject of several studies worldwide. Cesarean section is a commonly performed procedure and can lead to severe pain. This study aimed to determine the quality of post-cesarean analgesia by intrathecal administration of 100 micrograms of morphine. Patients and Methods: We conducted an analytical and descriptive study with prospective data collection during one month. We included all women who underwent a spinal caesarean section. Results: During the study period, a total of 119 women were enrolled. The mean age of the parturients was 27.85. High blood pressure and obesity were the most common comorbidities in 9.242% and 5.09% of the women respectively, and 31.93% had a history of caesarean section. Cesarean sections were performed according to the level of urgency based on the colour code. Scheduled caesarean sections were performed in 64.7% of cases. Women had an APFEL score of 3 in 95% of cases. Bupivacaine 7.5mg was administered in 96.63% of cases. The average dose of ephedrine administered before fetal extraction was 3.96mg. Oxytocin was the most administered uterotonic in 73.94%. The APGAR score at birth was greater than 7 in 95.79% of cases. No patient expressed a need for additional analgesics after lifting the motor block. No respiratory or neurological complications of morphine were noted. Pruritus was present in 24.36% of cases, whereas nausea and vomiting were reported in 17.64%. There were no cases of acute urine retention. The average time for the resumption of bowel movement was 13.67 hours. Discussion and Conclusion: Morphine spinal analgesia is an effective technique for the management of post-cesarean pain. The reduction of the morphine dose to 100 micrograms and the preventive addition of dexamethasone are two key factors in accelerated rehabilitation after surgery.