Comparison of the efficacy of different morphine doses added to ıntrathecal hyperbaric bupivacaine in cesarean section operations

Background: In a cesarean section, the well-being of both the mother and the fetus must be ensured. This adds a distinct complexity. Despite the increasing incidence of cesarean cases, the rise in the use of regional anesthesia techniques has led to a decrease in maternal mortality. Aims and Objectives: The objective is to compare maternal hemodynamic changes, sensory-motor blocks, side effects, and analgesia time with different morphine doses in cesarean anesthesia. Materials and Methods: A total of 60 patients, undergoing cesarean section surgery with spinal anesthesia at our center, were divided into three equal groups of 20 each, in a prospective, randomized, double-blind approach: Group I (SF) 0.5% hyperbaric bupivacaine+saline, Group II (M50) 0.5% hyperbaric bupivacaine+50 mcg morphine, and Group III (M100) 0.5% hyperbaric bupivacaine+100mcg morphine. Results: The time to reach the maximum sensory block level was fastest in the SF group and slowest in the M50 group (P=0.008). The time to reach the maximum motor block level was also faster in the SF group within the first 10 min (P<0.05). The time to the first analgesic requirement was longest in Group M100 and shortest in Group SF. From 30 min onward, the mean Visual Analogue Scale scores in Group M100 were significantly lower compared to the other two groups, while Group M50 was lower than Group SF (P<0.001). Conclusion: The addition of 50 mcg and 100 mcg morphine to intrathecal hyperbaric bupivacaine did not alter hemodynamic measurements or intraoperative and post-operative side effects. Intrathecal 100 mcg morphine was sufficient without the need for additional analgesia in the first 24 h postoperatively.