Efficacy and tolerability of intravenous morphine patient-controlled analgesia (PCA) in women undergoing cesarean delivery

Abstract

Objectives: The aim of the study was to evaluate analgesic efficacy and tolerability of patient-controlled analgesia (PCA) with intravenous morphine. Material and methods: Our observational study included 50 women who underwent a Misgav-Ladach or modified Misgav-Ladach cesarean section. Automated PCA infusion device (Medima S-PCA Syringe Pump, Medima, Krakow, Poland) was used for postoperative pain control. Time of morphine administration or initiation of intravenous patient-controlled analgesia (IV PCA) with morphine was recorded, as well as post-operative pain at rest assessed by a visual analogue scale (VAS). All patients were followed up for 24 hours after discharge from the operating room, taking into account patient records, worst pain score at rest, number of IV PCA attempts, and drug consumption. Results: Median of total morphine doses used during the postoperative period was 42.9mg (IQR 35.6–48.5), with median infusion time of 687.0 min. (IQR 531.0–757.5). Pain severity and total drug consumption improved after the first 3 hours following cesarean delivery (p<0.01). Mean number of PCA attempts per patient was 33 (IQR: 24–37), with median of 11 placebo attempts (IQR: 3–27). Conclusions: Patient-controlled analgesia with morphine is an efficient and acceptable analgesic method in women undergoing cesarean section.