Spinal drug allows childbirth to be a little less painful

February 21, 2007
The joys of new motherhood, especially in the hours just after delivery, can be many. But for women who experience a planned or unplanned cesarean section, the pain that results can leave them feeling anything but joyful. In recent years, however, better management of post-operative pain in C-section patients at New Hanover Regional Medical Center has resulted in the use of spinal duramorph, a preservative-free, morphine-based painkiller that can last up to 24 hours. An alternative to oral or IV-administered painkillers that can leave patients feeling “zonked,” spinal duramorph successfully quells post-operative, C-section pain with relatively few side effects, thus increasing the quality of early contact between mother and child and decreasing the length of hospital stay. “Duramorph is just one component of regional anesthesia that we can add that’s great for pain control,” said Moira Post, a certified registered nurse anesthetist at NHRMC. “It can add 12 to 24 hours of pain control, so patients aren’t requiring as much oral or IV pain medication, so they’re recovering quicker and going home quicker.” Regional anesthesia, either a spinal or epidural, is the preferred method of pain relief during a C-section. Spinal anesthesia involves a one-time injection of numbing medication into the spinal fluid using a very small needle, while epidural anesthesia involves an injection into an area outside the spinal fluid called the epidural space. With an epidural, a catheter, or tube, is then put in place, which allows for the steady flow of local anesthetic for an indefinite period of time. Duramorph can be administered either way. “We use duramorph because it diffuses out of the spinal space slowly, so the onset of pain control is slow and the duration is prolonged,” Post said. She described administering duramorph by way of spinal anesthetic prior to a C-section as fairly straightforward and minimally painful. “There is a small puncture made, the medicine is injected, the needle is removed, and the onset of anesthesia is fairly rapid, usually in about five to 10 minutes,” she said. Patients with spinals for C-sections remain awake throughout delivery in most cases, she said, adding that duramorph doesn’t affect the newborn. “Duramorph is used because it is placed in the mother’s spinal sac, decreasing the potential for the medicine to be transferred to the unborn baby,” she said. Post said with the use of duramorph a patient’s length of stay could be reduced by as much as one day, not to mention the overall positive effects of a stay that’s pain-free. “Everyone’s happy because we have the patient’s pain well-controlled, and patients are happy because they recover faster and get to leave earlier,” she said.For a referral to speak with an anesthesiologist or certified registered nurse anesthetist about duramorph, call VitaLine at 910.815.5188.