Working patterns of trainee anaesthetists in the UK: results of a national postal survey

✍ Scribed by A. McGill; S. P. Hutchinson; J. C. Andrzejowski; G. A. Francis

• Publisher: John Wiley and Sons
• Year: 2001
• Tongue: English
• Weight: 491 KB
• Volume: 56
• Category: Article
• ISSN: 0003-2409
• DOI: 10.1046/j.1365-2044.2001.01763-2.x

✦ Synopsis

Forty women undergoing elective Caesarean section under spinal anaesthesia using hyperbaric 0.5% bupivacaine were randomly allocated to receive either 0.5 mg or 1 mg intrathecal diamorphine. All women received diclofenac 100 mg at the end of surgery and morphine via a patient‐controlled analgesia system. Oral analgesics were not used. Postoperative analgesia was more prolonged and more reliable in the 1‐mg group. Mean time to first analgesia was 10.2 h in the 1‐mg group and 6.9 h in the 0.5‐mg group, and 45% in the 1‐mg group used no morphine, compared with 10% in the 0.5‐mg group. Mean morphine consumption over 24 h was 5.2 mg in the 1‐mg group and 10.6 mg in the 0.5‐mg group. Pain scores all tended to be lower in the 1‐mg group but this was only significant at 4 h. There were no serious side‐effects. Minor side‐effects were common but well tolerated, and the incidence did not differ between the groups. If intrathecal diamorphine is used in combination with rectal diclofenac and without oral analgesia, then 1 mg provides superior analgesia to 0.5 mg without any worsening of the side‐effects.