[Truncatet abstract] Introduction A variety of techniques are available for post-caesarean analgesia. As the number of caesarean deliveries increase in developed countries, so too does the research into post-caesarean pain. Opioids form the foundation of most multimodal analgesia regimens post-caesarean delivery but they have not been adequately studied by the oral route of administration. This approach has the potential to show an improved side effect profile compared to other routes of administration, greater maternal acceptability as well as potentially avoiding some of the complications associated with neuraxial based techniques. Aims This thesis has evaluated primary post-caesarean analgesia based on an oral opioid regimen with that provided by intrathecal morphine among women undergoing caesarean delivery under spinal anaesthesia. The secondary objectives included an evaluation of the side effects and acceptability of a multimodal analgesic regimen based on regular oral oxycodone. Methods After obtaining Institutional Ethics Committee approval and written informed consent, a double blind, double dummy, placebo controlled clinical trial was performed in which 120 women were randomised to receive either sustained-release oral oxycodone 20 mg in the recovery room followed by immediate-release oxycodone 10 mg 6-hourly for the first 24 h (Group O) or intrathecal morphine 100 mcg at the time of spinal anaesthesia (Group I). All women received regular post-operative diclofenac, paracetamol and standardised supplemental analgesia. The null hypothesis was that there would be no difference between the groups with respect to early post-operative analgesia. The primary endpoint for the study was the area under the curve for dynamic pain over the first 24 hours. The analysis was performed using SPSS 15.0 for Windows (SPSS, Chicago, IL)...
|Publication status||Unpublished - 2009|