Randomised control trial of oral morphine and intramuscular pethidine for post-caesarean section analgesia in South-Western Nigeria

Background: The search for the ideal analgesia following caesarean section remains elusive but opioids provide good postoperative analgesia. Intramuscular opioid induces pain at the site of injection and its repeated administration proved to be more demanding for caregivers. Oral opioids especially...

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Main Authors: Rofiat Temitope Lemboye-Bello, David Olalekan Awonuga, Adenike Abidemi Odewabi, Taofeek Ajani Ogunfunmilayo, Oluseyi Adedeji Aderinwale, Olanrewaju Saheed Jimoh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Nigerian Journal of Medicine
Subjects:
Online Access:http://www.njmonline.org/article.asp?issn=1115-2613;year=2022;volume=31;issue=6;spage=618;epage=624;aulast=Lemboye-Bello
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author Rofiat Temitope Lemboye-Bello
David Olalekan Awonuga
Adenike Abidemi Odewabi
Taofeek Ajani Ogunfunmilayo
Oluseyi Adedeji Aderinwale
Olanrewaju Saheed Jimoh
author_facet Rofiat Temitope Lemboye-Bello
David Olalekan Awonuga
Adenike Abidemi Odewabi
Taofeek Ajani Ogunfunmilayo
Oluseyi Adedeji Aderinwale
Olanrewaju Saheed Jimoh
author_sort Rofiat Temitope Lemboye-Bello
collection DOAJ
description Background: The search for the ideal analgesia following caesarean section remains elusive but opioids provide good postoperative analgesia. Intramuscular opioid induces pain at the site of injection and its repeated administration proved to be more demanding for caregivers. Oral opioids especially morphine have become increasingly accessible in our environment and may be more effective than the conventional parenteral opioids for postcaesarean analgesia. Aim: To compare the efficacy of multiple doses of 10 mg oral morphine with that of 50 mg intramuscular pethidine in treatment of postcaesarean pain among parturients in Abeokuta, Nigeria. Patients, Materials and Methods: The study was a randomised controlled trial among parturients who had elective caesarean section in Abeokuta between November 2019 and August 2020. A total of 136 consenting and eligible pregnant women were randomised into two groups. Group A received multiple doses of 10 mg oral morphine while Group B had multiple doses of 50 mg intramuscular pethidine. The summed pain intensity difference (SPID) of the two groups was calculated and compared using the Chi-square and P < 0.05 was statistically significant. Results: The mean ± standard deviation (SD) of SPID at rest for morphine group and pethidine group was 6.00 ± 76.25 and 8.51 ± 77.60, respectively (t = −0.439 P = 0.662); the mean ± SD of SPID on movement for morphine and pethidine group was 29.13 ± 75.25 and 25.52 ± 28.47 (t = 0.139, P = 0.890). The median maternal satisfaction reported was similar in both groups (χ2 = 2.773, P = 0.4963) and somnolence was experienced in 3.1% of parturients in morphine group. Conclusion: The efficacy and maternal satisfaction of oral morphine in the control of postcaesarean section pain was similar to that of intramuscular pethidine. Hence, oral morphine is an acceptable alternative to intramuscular pethidine in management of pain following Caesarean section.
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spelling doaj.art-825f911d6b514bf7ae92cc2f6304a4442023-07-21T12:56:26ZengWolters Kluwer Medknow PublicationsNigerian Journal of Medicine1115-26132022-01-0131661862410.4103/NJM.NJM_105_22Randomised control trial of oral morphine and intramuscular pethidine for post-caesarean section analgesia in South-Western NigeriaRofiat Temitope Lemboye-BelloDavid Olalekan AwonugaAdenike Abidemi OdewabiTaofeek Ajani OgunfunmilayoOluseyi Adedeji AderinwaleOlanrewaju Saheed JimohBackground: The search for the ideal analgesia following caesarean section remains elusive but opioids provide good postoperative analgesia. Intramuscular opioid induces pain at the site of injection and its repeated administration proved to be more demanding for caregivers. Oral opioids especially morphine have become increasingly accessible in our environment and may be more effective than the conventional parenteral opioids for postcaesarean analgesia. Aim: To compare the efficacy of multiple doses of 10 mg oral morphine with that of 50 mg intramuscular pethidine in treatment of postcaesarean pain among parturients in Abeokuta, Nigeria. Patients, Materials and Methods: The study was a randomised controlled trial among parturients who had elective caesarean section in Abeokuta between November 2019 and August 2020. A total of 136 consenting and eligible pregnant women were randomised into two groups. Group A received multiple doses of 10 mg oral morphine while Group B had multiple doses of 50 mg intramuscular pethidine. The summed pain intensity difference (SPID) of the two groups was calculated and compared using the Chi-square and P < 0.05 was statistically significant. Results: The mean ± standard deviation (SD) of SPID at rest for morphine group and pethidine group was 6.00 ± 76.25 and 8.51 ± 77.60, respectively (t = −0.439 P = 0.662); the mean ± SD of SPID on movement for morphine and pethidine group was 29.13 ± 75.25 and 25.52 ± 28.47 (t = 0.139, P = 0.890). The median maternal satisfaction reported was similar in both groups (χ2 = 2.773, P = 0.4963) and somnolence was experienced in 3.1% of parturients in morphine group. Conclusion: The efficacy and maternal satisfaction of oral morphine in the control of postcaesarean section pain was similar to that of intramuscular pethidine. Hence, oral morphine is an acceptable alternative to intramuscular pethidine in management of pain following Caesarean section.http://www.njmonline.org/article.asp?issn=1115-2613;year=2022;volume=31;issue=6;spage=618;epage=624;aulast=Lemboye-Belloanalgesiacaesarean sectionintramuscularmorphinepethidine
spellingShingle Rofiat Temitope Lemboye-Bello
David Olalekan Awonuga
Adenike Abidemi Odewabi
Taofeek Ajani Ogunfunmilayo
Oluseyi Adedeji Aderinwale
Olanrewaju Saheed Jimoh
Randomised control trial of oral morphine and intramuscular pethidine for post-caesarean section analgesia in South-Western Nigeria
Nigerian Journal of Medicine
analgesia
caesarean section
intramuscular
morphine
pethidine
title Randomised control trial of oral morphine and intramuscular pethidine for post-caesarean section analgesia in South-Western Nigeria
title_full Randomised control trial of oral morphine and intramuscular pethidine for post-caesarean section analgesia in South-Western Nigeria
title_fullStr Randomised control trial of oral morphine and intramuscular pethidine for post-caesarean section analgesia in South-Western Nigeria
title_full_unstemmed Randomised control trial of oral morphine and intramuscular pethidine for post-caesarean section analgesia in South-Western Nigeria
title_short Randomised control trial of oral morphine and intramuscular pethidine for post-caesarean section analgesia in South-Western Nigeria
title_sort randomised control trial of oral morphine and intramuscular pethidine for post caesarean section analgesia in south western nigeria
topic analgesia
caesarean section
intramuscular
morphine
pethidine
url http://www.njmonline.org/article.asp?issn=1115-2613;year=2022;volume=31;issue=6;spage=618;epage=624;aulast=Lemboye-Bello
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