The Effect of Intrathecal Administration of Different Doses of Morphine on Headache after Dural Puncture in Cesarean Sections Under Spinal Anesthesia: A Randomized Double-Blind Controlled Study

Abstract

Introduction: Intrathecal morphine is used to prevent post-dural puncture headache (PDPH). We aimed to investigate the effect of administering different doses of morphine intrathecally on PDPH in whom a cesarean section (CS) was performed under spinal anesthesia. Materials and Methods: 80 ASA I-II pregnant women were included in the study. They were randomly divided into four groups: F25: 2ml of hyperbaric bupivacaine+25µg of fentanyl intrathecally, M100: 2ml of hyperbaric bupivacaine +100µg of morphine intrathecally, M150: 2ml of hyperbaric bupivacaine+150µg of morphine intrathecally and M200: 2ml of hyperbaric bupivacaine+200µg of morphine intrathecally. The patients were monitored for postoperative headache, development of PDPH, the requirement for epidural blood patch (EBP), the EBP number, the duration of hospitalization, and side effects that might occur within the first 24 hours (drug allergy, nausea, vomiting, itching, apnea, desaturation). All patients were assessed using the visual analog scale (VAS) for seven days postoperatively. Results: The lowest rate of PDPD was determined in the M200. The highest VAS score of M200 was significantly lower than the other groups (p