Epidurally administered morphine for postcesarean analgesia.

A double blind study was performed to evaluate analgesia from epidurally injected morphine sulfate in 30 mothers after cesarean section following similar regional anesthetics. When compared with a saline placebo and 2 milligrams of epidurally injected morphine, a 4.5 milligram epidurally administered morphine dose resulted in a highly significant reduction in the initial 24 hour parenterally administered narcotic requirement, p less than 0.001, and a significantly greater duration of analgesia after epidural injection, p less than 0.0003. The mean duration of analgesia following 4.5 milligram epidural injection of morphine sulfate was 26.7 +/- 4.72 hours. A 2 milligram epidural dose reduced the initial 24 hour narcotic requirement, p less than 0.05, but the duration of analgesia did not significantly differ from that of placebo injection. No significant side-effects were noted. Epidurally administered morphine appears promising as a potent analgesic approach of extended duration with potential advantages for early maternal mobilization, improved fetal maternal interaction and reduced fetal narcotic exposure in the breast fed infant.