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Journal of Anesthesia

, Volume 31, Issue 1, pp 44–50 | Cite as

Cost comparison of intrathecal morphine to intravenous patient-controlled analgesia for the first 24 h post cesarean delivery: a retrospective cohort study

  • Nitesh Patel
  • Ayesha Bryant
  • Kensi Duncan
  • Promil Kukreja
  • Mark F. Powell
Original Article

Abstract

Purpose

Intrathecal morphine provides superior pain control for patients undergoing cesarean delivery when compared to intravenous opioid patient-controlled analgesia. However, no study has assessed the overall cost associated with each modality as a primary outcome. The aim of this study is to determine the overall cost of each modality for the first 24 h post cesarean delivery.

Methods

Charts of patients undergoing cesarean delivery at our institution from January 1, 2014 to December 31, 2014 were reviewed. Patients receiving intrathecal morphine were compared to patients undergoing general anesthesia and receiving intravenous opioid patient-controlled analgesia for post-procedure analgesia. The primary outcome measured was total cost of each modality for the first 24 h after delivery. Secondary outcomes included post-procedure pain scores, time to removal of the Foley catheter, need for rescue medications, and adverse events.

Results

There was a significant difference in total cost of intrathecal morphine when compared to intravenous opioid patient-controlled analgesia ($51.14 vs. $80.16, p < 0.001). Average pain scores between 0–1 h (0 vs. 5, p < 0.001) and 1–6 h (2.5 vs. 3.25, p < 0.001) were less in the intrathecal morphine group. The intrathecal morphine group received more ketorolac (p < 0.001) and required more rescue opioids (p = 0.042). There were no significant differences in documented adverse events.

Conclusions

The use of intrathecal morphine for post-cesarean pain control leads to a significant cost savings for the first 24 h when compared to intravenous opioid patient-controlled analgesia. Patients also experienced less pain and were not at increased risk for adverse events.

Keywords

Intrathecal morphine Cost analysis Post-cesarean pain control 

Notes

Compliance with ethical standards

Sole funding for this project was provided through departmental funds and had no involvement in the study design, data collection, and analysis.

Conflict of interest

The authors report no conflicts of interest.

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Copyright information

© Japanese Society of Anesthesiologists 2016

Authors and Affiliations

  • Nitesh Patel
    • 1
  • Ayesha Bryant
    • 1
  • Kensi Duncan
    • 2
  • Promil Kukreja
    • 1
  • Mark F. Powell
    • 1
  1. 1.Department of Anesthesiology and Perioperative MedicineUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Department of NursingUniversity of Alabama at BirminghamBirminghamUSA

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