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Comparison of epidural oxycodone and epidural morphine for post-caesarean section analgesia: A randomised controlled trial
BACKGROUND AND AIMS: Epidural morphine after caesarean section may cause moderate to severe pruritus in women. Epidural oxycodone has been shown in non-obstetric trials to reduce pruritus when compared to morphine. We hypothesised that epidural oxycodone may reduce pruritus after caesarean section....
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800935/ https://www.ncbi.nlm.nih.gov/pubmed/27053782 http://dx.doi.org/10.4103/0019-5049.177877 |
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author | Sng, Ban Leong Kwok, Sarah Carol Mathur, Deepak Ithnin, Farida Newton-Dunn, Clare Assam, Pryseley Nkouibert Sultana, Rehena Sia, Alex Tiong Heng |
author_facet | Sng, Ban Leong Kwok, Sarah Carol Mathur, Deepak Ithnin, Farida Newton-Dunn, Clare Assam, Pryseley Nkouibert Sultana, Rehena Sia, Alex Tiong Heng |
author_sort | Sng, Ban Leong |
collection | PubMed |
description | BACKGROUND AND AIMS: Epidural morphine after caesarean section may cause moderate to severe pruritus in women. Epidural oxycodone has been shown in non-obstetric trials to reduce pruritus when compared to morphine. We hypothesised that epidural oxycodone may reduce pruritus after caesarean section. METHODS: A randomised controlled trial was conducted in pregnant women at term who underwent caesarean section with combined spinal-epidural technique initiated with intrathecal fentanyl 15 μg. Women received either epidural morphine 3 mg or epidural oxycodone 3 mg via the epidural catheter after delivery. The primary outcome was the incidence of pruritus at 24 h after caesarean section. The secondary outcomes were the pruritus scores, treatment for post-operative nausea and vomiting (PONV), pain scores and maternal satisfaction. RESULTS: One hundred women were randomised (group oxycodone O = 50, morphine M = 50). There was no difference between Group O and M in the incidence of pruritus (n [%] 28 [56%] vs. 31 [62%], P = 0.68) and the worst pruritus scores (mean [standard deviation] 2.6 (2.8) vs. 3.3 [3.1], P = 0.23), respectively. Both groups had similar pain scores at rest (2.7 [2.3] vs. 2.0 [2.7], P = 0.16) and sitting up (5.0 [2.3] vs. 4.6 [2.4], P = 0.38) at 24 h. Pruritus scores were lower at 4–8, 8–12 and 12–24 h with oxycodone, but pain scores were higher. Both groups had a similar need for treatment of PONV and maternal satisfaction with analgesia. CONCLUSION: There was no difference in the incidence of pruritus at 24 h between epidural oxycodone and morphine. However, pruritus scores were lower with oxycodone between 4 and 24 h after surgery with higher pain scores in the same period. |
format | Online Article Text |
id | pubmed-4800935 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-48009352016-04-06 Comparison of epidural oxycodone and epidural morphine for post-caesarean section analgesia: A randomised controlled trial Sng, Ban Leong Kwok, Sarah Carol Mathur, Deepak Ithnin, Farida Newton-Dunn, Clare Assam, Pryseley Nkouibert Sultana, Rehena Sia, Alex Tiong Heng Indian J Anaesth Original Article BACKGROUND AND AIMS: Epidural morphine after caesarean section may cause moderate to severe pruritus in women. Epidural oxycodone has been shown in non-obstetric trials to reduce pruritus when compared to morphine. We hypothesised that epidural oxycodone may reduce pruritus after caesarean section. METHODS: A randomised controlled trial was conducted in pregnant women at term who underwent caesarean section with combined spinal-epidural technique initiated with intrathecal fentanyl 15 μg. Women received either epidural morphine 3 mg or epidural oxycodone 3 mg via the epidural catheter after delivery. The primary outcome was the incidence of pruritus at 24 h after caesarean section. The secondary outcomes were the pruritus scores, treatment for post-operative nausea and vomiting (PONV), pain scores and maternal satisfaction. RESULTS: One hundred women were randomised (group oxycodone O = 50, morphine M = 50). There was no difference between Group O and M in the incidence of pruritus (n [%] 28 [56%] vs. 31 [62%], P = 0.68) and the worst pruritus scores (mean [standard deviation] 2.6 (2.8) vs. 3.3 [3.1], P = 0.23), respectively. Both groups had similar pain scores at rest (2.7 [2.3] vs. 2.0 [2.7], P = 0.16) and sitting up (5.0 [2.3] vs. 4.6 [2.4], P = 0.38) at 24 h. Pruritus scores were lower at 4–8, 8–12 and 12–24 h with oxycodone, but pain scores were higher. Both groups had a similar need for treatment of PONV and maternal satisfaction with analgesia. CONCLUSION: There was no difference in the incidence of pruritus at 24 h between epidural oxycodone and morphine. However, pruritus scores were lower with oxycodone between 4 and 24 h after surgery with higher pain scores in the same period. Medknow Publications & Media Pvt Ltd 2016-03 /pmc/articles/PMC4800935/ /pubmed/27053782 http://dx.doi.org/10.4103/0019-5049.177877 Text en Copyright: © Indian Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Sng, Ban Leong Kwok, Sarah Carol Mathur, Deepak Ithnin, Farida Newton-Dunn, Clare Assam, Pryseley Nkouibert Sultana, Rehena Sia, Alex Tiong Heng Comparison of epidural oxycodone and epidural morphine for post-caesarean section analgesia: A randomised controlled trial |
title | Comparison of epidural oxycodone and epidural morphine for post-caesarean section analgesia: A randomised controlled trial |
title_full | Comparison of epidural oxycodone and epidural morphine for post-caesarean section analgesia: A randomised controlled trial |
title_fullStr | Comparison of epidural oxycodone and epidural morphine for post-caesarean section analgesia: A randomised controlled trial |
title_full_unstemmed | Comparison of epidural oxycodone and epidural morphine for post-caesarean section analgesia: A randomised controlled trial |
title_short | Comparison of epidural oxycodone and epidural morphine for post-caesarean section analgesia: A randomised controlled trial |
title_sort | comparison of epidural oxycodone and epidural morphine for post-caesarean section analgesia: a randomised controlled trial |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800935/ https://www.ncbi.nlm.nih.gov/pubmed/27053782 http://dx.doi.org/10.4103/0019-5049.177877 |
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