POSTOPERATIVE ANALGESIC EFFICACY OF EPIDURAL MORPHINE IN PATIENTS UNDERGOING CESAREAN SECTION, HOSPITAL ALFREDO G. PAULSON. NOVEMBER AND DECEMBER 2019.

Abstract

Opioids administered systemically/intravenously or through neuraxial anesthetic and analgesic techniques constitute a fundamental pillar in the routine management of acute postoperative pain control. Being Alfredo Hospital
G. Paulson the largest referral hospital for obstetric patients in the city of Guayaquil and in Ecuador. It was decided to carry out a study of patients who underwent cesarean section, between the months of November and December 2019. This study aims to add epidural morphine as part of an institutional protocol and multimodal analgesia in patients undergoing cesarean section. Comparing the postoperative analgesic efficacy between 2 groups: The first Group M., which consisted of 15 randomly selected patients who received epidural analgesia with 2 mg of morphine in addition to systemic analgesia with continuous infusion of tramadol and Group 0, which consisted of 15 randomly selected patients. who only received systemic analgesia with continuous infusion of tramadol as regulated in our hospital. Pain was evaluated using the Verbal Numerical Scale in the immediate postoperative URPA (Acute Postoperative Recovery Unit), and at 2, 6, 12, and 24 hours the evaluation was performed at rest and in motion. The results were that in Group M there was a higher percentage of patients without pain or mild pain during all the hours in which the evaluation was carried out. Likewise, only 7% of the patients reported intense postoperative pain at 24 hours postoperatively. While in Group 0 there was a constant of patients with pain from the evaluation in the immediate postoperative period (20%) and intense pain from 2 hours postoperative (7%). This, together with the fact that there were no serious adverse effects associated with analgesia with epidural morphine, allow us to validate the proposal that morphine increases the efficacy and quality of postoperative analgesia in post-cesarean section patients and that it should be included as part of the institutional protocol of the Hospital. Alfredo G. Paulson on multimodal analgesia in post-surgical obstetric patients