Effects of single injection of morphine into epidural space on efficacy and adverse reactions of patient controlled intravenous analgesia with oxycodone for women after cesarean section

Objective To study the effects of single injection of morphine into epidural space on the efficacy adverse reactions of patient controlled intravenous analgesia with oxycodone for wemen after cesarean section. Methods 80 ASA grade ⅠorⅡ parturients undergoing cesarean delivery were randomly divided into group A and group B, 40 cases for each group. 1.5 mg morphine (diluted with 5 ml saline) was injected into epidural cavity after the fetus was take out in group B, while the amount of saline was injected in group A. In both groups, epidura-spinal anesthesia was used and 3 mg oxycodone was administered intavenously after the cord clamped. Patient controlled intravenous analgesia with oxycodone was used for postoperative analgesia, and 27 mg oxycodone diluted with saline 100 ml for analgesic solution. The postoperative abdominal incision pain was evaluated using visual analogue scale (VAS) assessment at different time-points. The uterine contractions pain was evaluated using degree method 1 day and 2 days after operation. The adverse reactions were recorded. The analgesia satisfaction was adjudged by parturients. The level of serum prolactin (PRL) was determined with Chemiluminescence method using 2 ml venous blood sample 24 h after cesarean section. Results The VAS scores of incision 6 and 12 h after operation were significantly lower in group B than in group A (P 0.05). The degree of uterine contraction pain was significantly lower in group B than in group A (P 0.05). The times of breastfeeding for neonates after cesarean section was significantly more in group B than in group A (P<0.05). The maternal blood level of prolactin one day after operation was significantly higher in group B than in group A (P<0.05). The overall satisfaction of parturients for analgesia was significantly higher in group B than in group A (P<0.05). Conclusion The single injection of morphine into epidural space combined with intravenous analgesia with oxycodone is more effective than the intravenous analgesia with oxycodone, and is a good choice for postoperative analgesia for parturients after cesarean section. Key words: Epidural; Morphine; Postoperative analgesia; Patient controlled intravenous analgesia; Oxycodone; Cesarean section; Breastfeeding; Prolactin