Post-Caesarean Section Analgesia: A Comparison of Epidural Morphine and Nalbuphine

Author(s): Oinam Bisu Singh1 , Ashem Jack Meitei2 , L. Pradip Kumar Singh3 , N. Ratan Singh4 , Maharabam Binarani5 , V. Vasantharajan6 , N. Anita Devi7

BACKGROUND Epidural opioids can be used for postoperative pain management. The aim of this study is to compare the clinical profile of epidural morphine and nalbuphine following intra operative intrathecal bupivacaine, for post-operative analgesia in elective lower segment caesarean section. METHODS The study was conducted in 50 female patients who underwent elective lower segment caesarean section under spinal anaesthesia. Patients were randomly divided into two groups: Group M and Group N. All the patients in each group received 0.5% Bupivacaine 2 ml intrathecally. After which Group M received Morphine 2 mg diluted in 10 ml of 0.2% ropivacaine epidurally and Group N received Nalbuphine 2 mg diluted in 10 ml of 0.2% ropivacaine epidurally. Onset time and duration of first dose of epidural analgesia were recorded. Total amount of epidural morphine / nalbuphine, the total amount of rescue analgesia given during the postoperative period of first 24 hours along with side effect if any were noted. RESULTS The onset time of first dose of epidural analgesia was 11.72 ± 3.0 minute for Group M as compared to 7.48 ± 2.4 minute for Group N (p0.05) during the first 6 hours and 12 hours respectively following the first dose of epidural analgesia. CONCLUSIONS Epidural morphine when given for post-operative analgesia provides longer duration of analgesia and requires less rescue analgesia as compared to that of epidural nalbuphine.