No abstract

Background: Spinal anaesthesia is a common anaesthetic technique for caesarean sections. Neuraxial opioids such as intrathecal morphine may cause common adverse effects (pruritus, post-operative nausea and vomiting). Objectives: We investigated the incidence, severity and need for treatment of pruritus and post-operative nausea and vomiting following administration of intrathecal morphine in spinal anaesthesia for caesarean section at KK Women's and Children's Hospital, Singapore. Methods: We conducted a prospective study involving 124 parturients who received intrathecal morphine in spinal anaesthesia for caesarean section from October 2012 to October 2014. Results: Seventy patients (56.5%) had moderate or severe pruritus (score 4-10), while 54 patients (43.5%) had no or mild pruritus (score 0-3). Mean (SD) value of the worst pruritus score reported on a scale of 0-10 was 4 (2.59). Only seven out of the 124 patients (5.6%) required treatment for pruritus. With respect to distress and bother from itching in the past 24 hours on a score of 0-4, the mean score reported was 1.7 (1.23). Fourteen (11.2%) patients reported vomiting, dry-retching and nausea. Six (4.8%) patients had nausea that interfered with activities of daily living. Four (3.2%) patients had clinically significant postoperative nausea and vomiting. Seven (5.6%) patients received anti-emetics. The average Overall Benefit of Analgesia Score was 3.8 (SD 2.6, min-max: 0-15). The average (SD) maternal satisfaction with pain relief and side effects was 84.9% (9.9%). Conclusion: There is a high incidence of pruritus, with most women reporting moderate to severe pruritus. The incidence of post-operative nausea and vomiting is low, and women reported good maternal satisfaction.

To assess if there are differences in the sonoelastographic features between normal women and patients with endometrial cancer on transvaginal ultrasound.