Postoperative Epidural Analgesia in Cesarean Section: Comparison of Therapeutic Schemes.

Abstract

BackgroundCesarean section is associated with moderate to severe postoperative pain. Its adequate control is fundamental to postpartum functional recovery, prevention of chronic pain, and postpartum depression. In this context, neuraxial analgesia has shown superior results. However, the best pharmacological regimen is still unknown. This study intended to compare the performance of three epidural therapeutic schemes (0.1% ropivacaine combined with epidural morphine vs 0.2% ropivacaine combined with epidural morphine vs morphine bolus) in pain intensity and its adverse effects in the early postoperative period of cesarean section.MethodsA retrospective observational study was carried out. The sample included 204 women who underwent cesarean section after previous epidural catheter placement. Demographic and clinical data were collected. Pain intensity in rest, movement at 24 and 48 hours, and adverse effects (pruritus, nausea, sedation, respiratory depression, hypotension, urinary retention and paresthesias) were recorded. ResultsStatistical analysis revealed no differences in mean pain scores between groups on the first and second postoperative days. The incidence of adverse effects was significantly lower in the morphine bolus group.ConclusionEpidural morphine therapy is an effective option with an adequate safety profile. The addition of a local anesthetic seems to offer no benefit in this context, increasing the incidence of adverse effects.