Abstract

The efficacy of epidural hydromorphone for postoperative analgesia was evaluated in ten healthy women who underwent cesarean delivery with epidural anesthesia. They received up to two epidural doses of 1.5 mg hydromorphone. Durations of analgesia (mean ± SD) were 19.3 ± 4.3 hours and 17.3 ± 6.4 hours after the first and second epidural injections of hydromorphone, respectively. Incidences of adverse side effects were: pruritus, 56% to 70%; nausea, 11% to 20%; and vomiting, 0% to 10%. Mean maternal venous pCO₂ levels obtained 3 and 6 hours after the initial dose of hydromorphone did not differ significantly from the predrug level. In contrast, the mean venous pCO₂ obtained 3 hours after the second dose of hydromorphone was elevated significantly over the predrug value (p < 0.05), although the increase was not clinically important. No respiratory depression was detected by an apnea monitor to which all patients had been connected. This dose of epidural hydromorphone was safe and provided prolonged analgesia following cesarean section.