Optimal Intrathecal Morphine Dose in Scheduled Cesarean Delivery
Abstract
Up to 90% of patients experience pruritus after receiving intrathecal morphine (ITM) for cesarean delivery, which may manifest as excessive itching of the face, torso, or arms. Pruritus may cause severe discomfort, increase staff workload, delay initiation of breastfeeding, and decrease patient satisfaction. Effective analgesia is achieved with as little as 0.1 mg of ITM, which also prevents pruritus in most cases; however, many anesthesia providers give twice this amount. An evidence-based practice project was developed to encourage anesthesia providers to use the 0.1 mg dose as a strategy to prevent pruritus. An initial chart review was completed on 30 cesarean deliveries, finding 37% were given treatment for pruritus. An educational presentation and knowledge assessment were conducted to encourage the new dosing strategy. Two months following the presentation, another 30 charts were reviewed and analyzed for post-intervention outcomes. Treatment-required pruritus in the 0.1mg group was 13% vs 57% in the 0.2 mg group. Of the providers who participated, 56% indicated they would change their practice long-term in favor of the 0.1 mg dose of ITM.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 24, 2020
- Accession Number
- AD1182684
Entities
People
- Brian Curtis
- Chris Payne
- Devon Dan
- Shaun Dunston
Organizations
- Uniformed Services University of the Health Sciences