EPIDURAL MORPHINE PRETREATMENT FOR POSTEPISIOTOMY PAIN

Objective/Design: A randomized double-blind controlled study was condu cted on two groups of 45 parturients to evaluate the importance of the timing of epidural morphine administration for the relief of postepis iotomy pain. Both groups had preemptive analgesia by continuous lumbar epidural bupivacaine blockade. Upon completion of the episiotomy repa ir and before the onset of pain, the patients received epidural inject ions of 3 ml saline with or without 2 mg morphine in groups A and B re spectively. When pain appeared, group A patients received an epidural injection of 3 ml saline while group B patients received 2 mg morphine in 3 ml saline. Postepisiotomy pain level was evaluated by a visual a nalogue scale. Results: The incidence of pain in group B women followi ng epidural morphine administration was 68.6%. This was significantly higher than that of group A at 15.6% (p < 0.01). Furthermore, group B showed that the rate of effective pain relief after 2 mg epidural morp hine significantly decreases as the level of pain intensity rises (p < 0.01). Conclusion: Epidural morphine for postepisiotomy pain is much more effective if administered before the onset of pain.