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The Use of Combined Spinal-Epidural Analgesia Utilizing Intrathecal Morphine for Labor Pain in a Community Hospital | OMICS International | Abstract
ISSN: 2155-6148

Journal of Anesthesia & Clinical Research
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Research Article

The Use of Combined Spinal-Epidural Analgesia Utilizing Intrathecal Morphine for Labor Pain in a Community Hospital

Alexander G Shilkrut1 , Elena V Kuklina2 , Cynthia Xenakis1 , Mario A Inchiosa Jr3 , Shelly M Nitz1 and Michael Girshin1 *

1Departments of Anesthesiology, and Obstetrics and Gynecology, New York Medical College, Metropolitan Hospital, New York, NY, USA

2Graduate Division of Biological and Biomedical Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA

3Departments of Pharmacology and Anesthesiology New York Medical College, Valhalla, NY, USA

*Corresponding Author:
Michael Girshin
Departments of Anesthesiology
Metropolitan Hospital Center, New York, USA
Fax: 2124238807
E-mail: [email protected]

Received Date: August 19, 2013; Accepted Date: October 16, 2013; Published Date: October 18, 2013

Citation: Shilkrut AG, Kuklina EV, Xenakis C, Inchiosa Jr MA, Nitz SM, et al. (2013) The Use of Combined Spinal-Epidural Analgesia Utilizing Intrathecal Morphine for Labor Pain in a Community Hospital. J Anesth Clin Res 4:356. doi: 10.4172/2155-6148.1000356

Copyright: © 2013 Shilkrut AG, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Purpose: To assess the incidence of adverse outcomes in pre-selected laboring patients who received low dose intrathecal morphine as part of the regional technique for labor analgesia.

Methods: Retrospective observational study of 205 laboring patients who delivered at a large community hospital between January 2007 and December 2010. All patients received Duramorph, 250 μg, and fentanyl, 25 μg intrathecally. The primary adverse outcome was delayed maternal respiratory depression. Secondary adverse outcomes included high pain scores, low Apgar scores, and postpartum hemorrhage.

Results: No cases of respiratory depression requiring naloxone administration were reported during the study. No infants had Apgar scores <7 at five minutes for reasons related to anesthesia, 25% of patients (N=53) underwent cesarean section, and <1% of deliveries (N=2) were complicated by postpartum hemorrhage. Among all study participants, only 4% (N=9) had pain scores >4.

Conclusion: This study demonstrates that regional analgesia utilizing low doses of intrathecal morphine and fentanyl in selected laboring patients is safe and effective.


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