Abstract
Introduction: The effectiveness of intrathecal (IT) morphine for post caesarean delivery (CD) analgesia is well established internationally as part of a multimodal analgesic regimen. [1] Sutton CD, Carvalho B. Optimal pain management after cesarean delivery. Anesthesiol Clin 2017;35:107–24. Google Scholar UK obstetric anaesthetic practice has favoured IT diamorphine. Our institution adopted IT morphine and fentanyl (morphine+fentanyl) as an adjuvant to hyperbaric bupivacaine for CD from 2019 due to supply issues. Given differences in lipid solubility of the two drugs, IT morphine could have prolonged effects, resulting in superior analgesia at 24 h post CD, but at the risk of worse side effects (nausea, pruritus). Given the multidimensional nature of post-CD recovery, IT morphine could result in poorer overall quality of recovery.
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