150 posters, 16 sessions, 294 authors, 70 institutions
ePostersLive by SciGen Technologies S.A. All rights reserved.
Obstetric Anaesthesia Annual Scientific Meeting 2024
Thursday 9 - Friday 10 May 2024, Birmingham
6299763
A tale of two spinals -- does choice of intrathecal opiates at caesarean delivery impact recovery? A three year, multi-site review.
Poster Presenter
Part of Topic
Introduction: A transition to intrathecal (IT) fentanyl and morphine in spinal anaesthesia for caesarean delivery (CD) was required due to diamorphine shortages. This may have led to differences in post-operative analgesia, affecting recovery from CD. We assessed the impact on length of stay (LoS) as a marker of recovery.
Methods: Three maternity units were retrospectively studied. Ayrshire Maternity Unit (AMU) uses fentanyl and morphine since swapping in Feb 2022, Queen Elizabeth University Hospital (QEUH) swapped to fentanyl and morphine for two weeks in Feb 2022 and Royal Alexandria Hospital (RAH) never swapped.
The previous three years of CDs were reviewed. Patients who received a general anaesthetic, epidural “top-up” for procedure or had incomplete data were excluded.
A Cox Proportional Hazards model assessed the impact of IT opiate on LoS, adjusting for these confounders:
Results: 14,474 CDs in study period of which 8,456 were eligible.
On Cox Proportional Hazards model the hazard ratio was 0.92 [95% CI 0.48 to 1.01, p=0.09. Indicating those who received fentanyl and morphine were 8% more likely to be discharged home earlier.
Discussion: The multivariate review indicates there is no significant difference between groups.
Anaesthetists, if there are further diamorphine shortages, can confidently use IT morphine and fentanyl as an alternative as recommended by NICE guideline 192 for CD without concern of a negative impact on recovery.