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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....

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Autores principales: Sng, Ban Leong, Kwok, Sarah Carol, Mathur, Deepak, Ithnin, Farida, Newton-Dunn, Clare, Assam, Pryseley Nkouibert, Sultana, Rehena, Sia, Alex Tiong Heng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
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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.
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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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