A comparison of the Analgesic and Side Effects of Epidural Morphine and Nalbuphine-Morphine Mixture in Post-Cesarean Section Patients

Lee, Youn Woo; Lee, Ja Won; Yoon, Duck Mi; Oh, Hung Kun

Abstract

The effect of epidural nalbuphine on pruritus, nausea, vomiting, voiding difficulties and/or analgesia induced by epidural morphine was determined in sixty Cesarian delivery patients. They were physical status l or 2 by ASA classification and randomly divided into three groups. They were administered morphine 3 mg only (group A), nalbuphine 5 mg with morphine 3 mg (group B), or nalbuphine 10 mg with morphine 3 mg (group C) at the time of peritoneal closure. During postoperative 24 hours their analgesic effects were evaluated by visual analogue scale (0-l0). Respiratory rates, Trieger dot test and severity of side effects (0-2) were also evaluated. The results were as follows; 1)Analgesic duration of the first epidural administration was significantly long in group A than other groups, but there was no difference between that of group B and group C. 2) Pruritus was more severe in group A than other groups but the severity was decreased by increasing nalbuphine dosage. 3) Nausea and or vomiting was mild in group C and the incidence of nausea andlor vomiting combined with pruritus was decrgased by increasing nalbuphine dosage. 4) Voiding difficulties was more severe in group A than other groups but the severity was not decreased by increasing nalbuphine dosage. 5) None of the patients had objective sedation or low respiration rate (< 10 times/minute). We concluded that epidural administration of nalbuphine l0 mg with morphine 3mg for post Cesarean section pain management is one of good methods to reduce side effects induced by epidural morphine.