دورية أكاديمية
Efficacy and Safety of Intrathecal Morphine for Cesarean Delivery: A Narrative Review.
| العنوان: | Efficacy and Safety of Intrathecal Morphine for Cesarean Delivery: A Narrative Review. |
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| المؤلفون: | Kaye AD; Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA., Lindberg AM; School of Medicine, Louisiana State University Health Sciences Center at New Orleans, New Orleans, LA, 70112, USA., Shah SS; School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA., Maitski RJ; School of Medicine, Louisiana State University Health Sciences Center at New Orleans, New Orleans, LA, 70112, USA., Pendarvis EB; School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA., Cooley JF; School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA., Amarasinghe S; Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA., Patel S; Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA., Palowsky Z; Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA., Fox CJ; Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA., Ahmadzadeh S; Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA., Shekoohi S; Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA. sahar.shekoohi@lsuhs.edu., Robinson CL; Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. |
| المصدر: | Current pain and headache reports [Curr Pain Headache Rep] 2024 Jul 08. Date of Electronic Publication: 2024 Jul 08. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Current Science Inc Country of Publication: United States NLM ID: 100970666 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-3081 (Electronic) Linking ISSN: 15343081 NLM ISO Abbreviation: Curr Pain Headache Rep Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Philadelphia, PA : Current Science Inc., c2001- |
| مستخلص: | Purpose of Review: Pain management is a critical aspect of care during and following a cesarean delivery. Without proper control of pain, individuals can experience poor mobility, increased thromboembolic events, and difficulty caring for the neonate in the postpartum period. There have been multiple methods for pain management for cesarean delivery and intrathecal morphine (ITM) has emerged as a prominent option for post-operative analgesia due to its efficacy, safety, and potential benefits over other treatments. This review analyzes data on efficacy, side effects, and safety of ITM and the pain control alternatives. Recent Findings: A comprehensive literature review was conducted to compare ITM with other analgesic techniques in post-cesarean patients. ITM was found to be as effective or better than other analgesic options, including bilateral quadratus lumborum block (QLB), opioid-free epidural analgesia (CSEA-EDA), and intravenous fentanyl. One study found that both ITM and oral analgesia were effective in pain control and that ITM caused fewer breakthrough pain events but had a longer duration and a greater rate of side effects than oral opioid analgesia. Commonly observed side effects of intrathecal opioids include nausea, vomiting, pruritus, and urinary retention, and it is thought that the adverse effects from intrathecal administration of opioids are short-lived. ITM may provide a decreased risk of DVT and coagulation by decreasing lower extremity weakness and numbness, thereby decreasing recovery time and increasing mobility. ITM is a safe and effective option for post-cesarean analgesia, with comparable pain relief to alternative forms of pain control, and side effects that are generally manageable. Further research is warranted to explore beneficial combinations with other methods of pain management and optimal dosing strategies. (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) |
| References: | Molina G, Weiser TG, Lipsitz SR, et al. Relationship between cesarean delivery rate and maternal and neonatal mortality. JAMA. 2015;314(21):2263. https://doi.org/10.1001/jama.2015.15553 . (PMID: 10.1001/jama.2015.1555326624825) Boerma T, Ronsmans C, Melesse DY, et al. Global epidemiology of use of and disparities in caesarean sections. The Lancet. 2018;392(10155):1341–8. https://doi.org/10.1016/S0140-6736(18)31928-7 . (PMID: 10.1016/S0140-6736(18)31928-7) Betran AP, Ye J, Moller AB, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health. 2021;6(6):e005671. https://doi.org/10.1136/bmjgh-2021-005671 . (PMID: 10.1136/bmjgh-2021-005671341309918208001) Gadsden J, Hart S, Santos AC. Post-cesarean delivery analgesia. Anesth Analg. 2005;101(5S):S62–9. https://doi.org/10.1213/01.ANE.0000177100.08599.C8 . (PMID: 10.1213/01.ANE.0000177100.08599.C816334493) Kessous R, Weintraub AY, Wiznitzer A, et al. Spinal versus general anesthesia in cesarean sections: the effects on postoperative pain perception. Arch Gynecol Obstet. 2012;286(1):75–9. https://doi.org/10.1007/s00404-012-2265-y . (PMID: 10.1007/s00404-012-2265-y22382371) Ring L, Landau R, Delgado C. The current role of general anesthesia for cesarean delivery. Curr Anesthesiol Rep. 2021;11(1):18–27. https://doi.org/10.1007/s40140-021-00437-6 . (PMID: 10.1007/s40140-021-00437-6336429437902754) Bollag L, Lim G, Sultan P, et al. Society for obstetric anesthesia and perinatology: Consensus statement and recommendations for enhanced recovery after cesarean. Anesth Analg. 2021;132(5):1362–77. https://doi.org/10.1213/ANE.0000000000005257 . (PMID: 10.1213/ANE.000000000000525733177330) Lim G, Facco FL, Nathan N, Waters JH, Wong CA, Eltzschig HK. A review of the impact of obstetric anesthesia on maternal and neonatal outcomes. Anesthesiology. 2018;129(1):192–215. https://doi.org/10.1097/ALN.0000000000002182 . (PMID: 10.1097/ALN.000000000000218229561267) Hermanns H, Bos EME, Van Zuylen ML, Hollmann MW, Stevens MF. The options for neuraxial drug administration. CNS Drugs. 2022;36(8):877–96. https://doi.org/10.1007/s40263-022-00936-y . (PMID: 10.1007/s40263-022-00936-y358360379345828) Pangthipampai P, Dejarkom S, Poolsuppasit S, Luansritisakul C, Tangchittam S. Bilateral posterior Quadratus Lumborum block for pain relief after cesarean delivery: a randomized controlled trial. BMC Anesthesiol. 2021;21(1):90. https://doi.org/10.1186/s12871-021-01309-6 . (PMID: 10.1186/s12871-021-01309-6337618947992995) Siti Salmah G, Choy YC. Comparison of morphine with fentanyl added to intrathecal 0.5% hyperbaric bupivacaine for analgesia after caesarean section. Med J Malaysia. 2009;64(1):71–4. (PMID: 19852327) Suzuki H, Kamiya Y, Fujiwara T, Yoshida T, Takamatsu M, Sato K. Intrathecal morphine versus epidural ropivacaine infusion for analgesia after Cesarean section: a retrospective study. JA Clin Rep. 2015;1(1):3. https://doi.org/10.1186/s40981-015-0005-6 . (PMID: 10.1186/s40981-015-0005-629497635) Loane H, Preston R, Douglas MJ, Massey S, Papsdorf M, Tyler J. A randomized controlled trial comparing intrathecal morphine with transversus abdominis plane block for post-cesarean delivery analgesia. Int J Obstet Anesth. 2012;21(2):112–8. https://doi.org/10.1016/j.ijoa.2012.02.005 . (PMID: 10.1016/j.ijoa.2012.02.00522410586) Sharpe EE, Molitor RJ, Arendt KW, et al. Intrathecal morphine versus intrathecal hydromorphone for analgesia after cesarean delivery. Anesthesiology. 2020;132(6):1382–91. https://doi.org/10.1097/ALN.0000000000003283 . (PMID: 10.1097/ALN.000000000000328332251031) Yefet E, Nassar S, Carmeli J, et al. Oral analgesia in fixed-time interval administration versus spinal morphine for post-Cesarean pain: a randomised controlled trial. Arch Gynecol Obstet. 2022;305(4):893–901. https://doi.org/10.1007/s00404-021-06196-3 . The study by Yefet, et al. was beneficial in this review due to its large number of patients involved in the randomized controlled trial, as well as its discussion of both efficacy and safety of the use of intrathecal morphine versus an alternative form of analgesia. (PMID: 10.1007/s00404-021-06196-334463805) Sato I, Iwasaki H, Luthe SK, Iida T, Kanda H. Comparison of intrathecal morphine with continuous patient-controlled epidural anesthesia versus intrathecal morphine alone for post-cesarean section analgesia: a randomized controlled trial. BMC Anesthesiol. 2020;20(1):138. https://doi.org/10.1186/s12871-020-01050-6 . (PMID: 10.1186/s12871-020-01050-6324933727268233) Yan ZR, Chen LJ, Zhang SJ, et al. The transversus abdominis plane block in conjunction with intrathecal morphine use after cesarean section in women with severe pre-eclampsia: a randomized controlled trial. BMC Anesthesiol. 2023;23(1):100. https://doi.org/10.1186/s12871-023-02061-9 . (PMID: 10.1186/s12871-023-02061-93699785310061731) Benyamin R, Trescot AM, Datta S, et al. Opioid complications and side effects. Pain Physician. 2008;11(2 Suppl):S105-120. (PMID: 10.36076/ppj.2008/11/S10518443635) Grape S, El-Boghdadly K, Albrecht E. Management of adverse effects of intrathecal opioids in acute pain. Best Pract Res Clin Anaesthesiol. 2023;37(2):199–207. https://doi.org/10.1016/j.bpa.2023.02.002 . (PMID: 10.1016/j.bpa.2023.02.00237321767) Morphine - an overview | ScienceDirect Topics. Accessed February 27, 2024. https://www.sciencedirect.com/topics/neuroscience/morphine . Fei L, Shuai H, Chen Z, Jie Y, Zhefeng Q. Efficacy and safety of low-dose versus high-dose postoperative intrathecal morphine in 62 women undergoing elective cesarean section delivery at full term. Med Sci Monit. 2023;29:0–0. https://doi.org/10.12659/MSM.939567 . The study by Fei, et al. was important to this review as it detailed some of the main adverse effects and safety concerns that are being considered when using intrathecal morphine during cesarean delivery. (PMID: 10.12659/MSM.939567) Gautier N, Lejeune D, Al Zein L, et al. The effects of intrathecal morphine on urinary bladder function and recovery in patients having a cesarean delivery - A randomized clinical trial. Anaesth Crit Care Pain Med. 2023;42(6):101269. https://doi.org/10.1016/j.accpm.2023.101269 . Siti Salmah G, Choy YC. Comparison of morphine with fentanyl added to intrathecal 0.5% hyperbaric bupivacaine for analgesia after caesarean section. Med J Malays. 2009;64(1):71–4. Fei L, Shuai H, Chen Z, Jie Y, Zhefeng Q. Efficacy and safety of low-dose versus high-dose postoperative intrathecal morphine in 62 women undergoing elective cesarean section delivery at full term. Med Sci Monit Int Med J Exp Clin Res. 2023;29:e939567–1–e939567–6. https://doi.org/10.12659/MSM.939567 . (PMID: 10.12659/MSM.939567) Sun C, Wang YT, Dai YJ, Liu ZH, Yang J, Cheng ZQ, Dong DS, Wang CF, Zhao GL, Lu GJ, Song T, Jin Y, Sun LL, Kaye AD, Urits I, Viswanath O, Sun YH. Intrathecal morphine delivery at cisterna magna to control refractory cancer-related pain: a prospective cohort study. Psychopharmacol Bull. 2020;50(4 Suppl 1):48–66. PMID: 33633417; PMCID: PMC7901124. (PMID: 336334177901124) Herman JA, Urits I, Kaye AD, Urman RD, Viswanath O. Racial disparities in obstetric outcomes and anesthetic techniques for deliveries. J Clin Anesth. 2022;79:109989. https://doi.org/10.1016/j.jclinane.2020.109989 . Epub 2020 Jul 24 PMID: 32718775. (PMID: 10.1016/j.jclinane.2020.10998932718775) |
| فهرسة مساهمة: | Keywords: Analgesia; Cesarean; Efficacy; Intrathecal morphine; Pain management; Safety |
| تواريخ الأحداث: | Date Created: 20240708 Latest Revision: 20240708 |
| رمز التحديث: | 20240708 |
| DOI: | 10.1007/s11916-024-01292-w |
| PMID: | 38976173 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1534-3081 |
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| DOI: | 10.1007/s11916-024-01292-w |