EFFECT OF EXTRADURAL DIAMORPHINE ON ANALGESIA AFTER CESAREAN-SECTION UNDER SUBARACHNOID BLOCK

We have examined the efficacy, duration of action and side effects of extradural diamorphine alone and in combination with 1:200000 adrenali ne in a randomized, double-blind controlled study of 45 patients who u nderwent Caesarean section under spinal anaesthesia. Saline 10 ml, dia morphine 2.5 mg in saline 10 ml or diamorphine 2.5 mg in 1:200000 adre naline 10 ml were administered via the extradural route at delivery of the baby. Both diamorphine and diamorphine with adrenaline provided s ignificantly prolonged analgesia compared with control (mean time to n ext analgesia (95% confidence interval) 17.3 h (12.0, 22. 1 h), 15.9 h (10.6, 21.1h), 5.7h (1.5, 9.9h), respectively) (P < 0.01). The additi on of adrenaline increased the quality of analgesia 8 h after operatio n, but had no effect on the total amount of im. morphine administered during the first 24 h. The incidence of side effects was similar in al l groups.