Patient choice compared with no choice of intrathecal morphine dose for caesarean analgesia: a randomized clinical trial B. Carvalho, F. Mirza, P. Flood

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Presentation transcript:

Patient choice compared with no choice of intrathecal morphine dose for caesarean analgesia: a randomized clinical trial B. Carvalho, F. Mirza, P. Flood British Journal of Anaesthesia Volume 118, Issue 5, Pages 762-771 (May 2017) DOI: 10.1093/bja/aex039 Copyright © 2017 The Author(s) Terms and Conditions

Fig 1 Flow diagram showing the breakdown of the randomization of women and the percentage of women offered a perceived choice of 100- or 200-μg intrathecal morphine compared with those actually receiving the dose. British Journal of Anaesthesia 2017 118, 762-771DOI: (10.1093/bja/aex039) Copyright © 2017 The Author(s) Terms and Conditions

Fig 2 Perceived choice of intrathecal morphine (ITM) dose 100 μg compared with 200 μg and post-caesarean delivery pain and side effects. (A and B) Box and whiskers plots representing verbal numerical rating scores (NRSs; scale 0–10) for pain on sitting, where horizontal bar is the mean, top and bottom of the box represent the 25th and 75th percentile values, error bars represent 5 and 95% values, and circles represent outlier values. (A) Patients who preferred a dose of 100-μg ITM for caesarean delivery analgesia had less pain on movement [1.2 (95% CI 0.5–1.9) NRS points] compared with (B) patients who preferred a 200-μg dose of ITM, regardless of dose actually received (P = 0.0008). (C and D) NRS for pruritus. Each line represents the experience of an individual patient during the 48 h after caesarean delivery. A small offset has been introduced to facilitate visualization of the many patients with zero values. (C) Patients who preferred the 100-μg ITM had similar levels of pruritus as compared with (D) those who preferred the 200-μg dose (P = 0.96). British Journal of Anaesthesia 2017 118, 762-771DOI: (10.1093/bja/aex039) Copyright © 2017 The Author(s) Terms and Conditions

Fig. 3 Pharmacologic side effects from the intrathecal morphine (ITM) dose given. Graphs are lines connecting verbal numerical rating scores (NRS; scale 0–10) for nausea (A and B) and pruritus (C and D) indicating the trajectory for each patient. Lines are slightly offset horizontally to allow for visualization of many overlying zero values. (A) Patients who received 200-μg ITM had more nausea compared with (B) patients who received the 100-μg dose {difference in area under the curve [NRS (0–10) × time (hours)] 33 (95% CI 24–43); P = 0.001}. (C) Women who received the 200-μg ITM dose had more pruritus compared with (D) patients who received the 100-μg dose [difference in area under the curve 26 (95% CI 14–109); P < 0.001]. British Journal of Anaesthesia 2017 118, 762-771DOI: (10.1093/bja/aex039) Copyright © 2017 The Author(s) Terms and Conditions