The effects of various doses of intrathecal morphine in addition with ropivacaine in combined spinal-epidural technique for labour analgesia

Abstract

We evaluated the duration of analgesia, side effects and neonatal effects of intrathecal ropivacaine combined with two different doses of morphine using combined spinal epidural (CSE) technique for labour analgesia. Fourty term parturients were enrolled. Group I received 0,2% ropivacaine 3 mg + morphine 50 μg and Group II received 0,2% ropivacaine 3 mg + morphine 100 μg intrathecally.When VAS for pain was equal or above 30 mm, PCEA(Patient controlling epidural analgesia) was started using 0,1% ropivacaine.
There wasn't any statistical significant difference considering the duration of analgesia between two groups. The first stage of labour was significantly shorter in Group II then Group I, and the epidural local anaesthetic volume was significantly lower in Group II. The most common side effect in both groups was pruritis. There was not any side effect of local anaesthetic and opioid on the newborns. Adequate analgesia was obtained during labour with CSE technique, using ropivacaine combined with 50 and 100 μg morphine intrathecally. However cervical dilatation was faster and epidural local anaesthetic volume was lower in the group in which 100 μg morphine was used. Also considering the unchanged incidence of the side effects, 3 mg 0,2% ropivacaine + 100 μg morphine may be a useful combination for labour analgesia.