Naloxone for managing adverse effects of intrathecal morphine in spinal anesthesia

Abstract

Objective. Appreciate the effectiveness of antidote to pain killers in the treatment of the side effects of morphine administered intrathecally and its impact on post-operative pain

Patients and method. The study was a prospective, randomized, single-blind "case-control" study that took place over one year (November 1, 2023 - December 1, 2024). it focused on cesarean patients under spinal anesthesia. Were included: parturient ASA 1 and 2 eligible for a cesarean section under spinal anesthesia and having a size greater than 150 cm. All patients benefited from the same anesthetic protocol. The "case" population received 40 microgramme of naloxone systematically on IVD at the end of the intervention (M0). This was repeated only once in the sixtieth minute (M60) in the presence of adverse effects. side effects were researched and the level of pain assessed during the first 24 hours after cesarean. The socio-demographic, clinical parameters, the side effects of morphine, post-operative pain as well as patient satisfaction were studied.

Results. Tree hundred (300) were selected. One hundred and fifty (150) received naloxone and the other 150 were controls. Their average age was 25,5 years. There was a regression of pruritus (p=0,001) without signifiant change in analgesia in the population who received naloxone. There was no signifiant difference in the occurence of postoperative nausea and vomiting (p>0,05). the "case" patients were more satisfied with the anesthetic protocol the " control" patients (p=0,0023)

Conclusion. Naloxone could improve the confort of patients receiving spinal anesthesia using morphine as adjuvant.