90265
document
2-Chloroprocaine antagonism of epidural morphine analgesia . BACKGROUND 2-Chloroprocaine ( 2-CP ) used for lumbar epidural anesthesia ( LEA ) reportedly decreases the efficacy of epidural morphine ( EM ) administered for post-cesarean section ( CS ) analgesia . The amount of supplemental i.v . morphine self-administered by the patient via the patient-controlled analgesia device ( PCA ) is used to study the interaction between EM and 2-CP . METHODS Forty-two patients scheduled for elective CS were randomly divided into 3 equal groups , and received 2-CP , 2-CP + epinephrine ( Epi , 5 micrograms.ml-1 ) or 2 % lidocaine ( Lido ) with Epi for LEA . All patients received 5 mg EM and i.v . PCA morphine for postoperative pain . Cumulative amount of i.v . morphine used in the first 24 hours as well as the amount of the drug used during each 2-h period were noted . Nonparametric analysis of variance and Chi-squared analysis were used for statistical comparisons . RESULTS The mean cumulative 24-h i.v . PCA morphine requirement in the 2-CP , 2-CP+Epi and Lido+Epi groups respectively was 20.5 +/- 24 , 33.1.5 +/- 27 and 4.07 +/- ( mean +/- SD ) . The Lido + Epi group used significantly less morphine ( P = 0.01 ) compared to either of the 2-CP groups with no significant difference between the 2-CP groups . The maximum i.v . PCA morphine use occurred in the first 4 hours following surgery in all three groups . CONCLUSION Analgesic efficacy of EM is decreased when 2-CP is used for LEA compared to when Lido + Epi is used .
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Intervention_Pharmacological
2-Chloroprocaine
90267
Intervention_Pharmacological
2-Chloroprocaine ( 2-CP )
90268
Intervention_Pharmacological
morphine ( EM )
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Intervention_Pharmacological
morphine
90270
Intervention_Pharmacological
EM
90271
Intervention_Pharmacological
2-CP
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Intervention_Pharmacological
2-CP
90273
Intervention_Pharmacological
2-CP + epinephrine
90274
Intervention_Pharmacological
2 % lidocaine ( Lido ) with Epi
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Intervention_Pharmacological
EM
90276
Intervention_Pharmacological
PCA morphine
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Intervention_Pharmacological
morphine
90278
Intervention_Pharmacological
2-CP
90279
Intervention_Pharmacological
2-CP+Epi
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Intervention_Pharmacological
2-CP
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Intervention_Pharmacological
2-CP
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Intervention_Pharmacological
morphine
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Intervention_Pharmacological
EM
90284
Intervention_Pharmacological
2-CP
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Intervention_Pharmacological
Lido + Epi
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Outcome_Other
Cumulative amount of i.v . morphine used in the first 24 hours
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Outcome_Other
amount of the drug used during each 2-h period
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Outcome_Other
mean cumulative 24-h i.v . PCA morphine requirement
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Outcome_Other
less morphine
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Outcome_Other
maximum i.v . PCA morphine use
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Outcome_Other
Analgesic efficacy
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Participant_Condition
post-cesarean section ( CS )