A Randomized, Controlled Trial of Rectus Sheath Bupivacaine and Intrathecal Bupivacaine, Without or with Intrathecal Morphine, Versus Intrathecal Bupivacaine and Morphine after Caesarean Section

(Anaesthesia 2017;72:1225–1229) Adequate analgesia after cesarean delivery plays a role in earlier mobilization after surgery and discharge from the hospital. Intrathecal morphine is one of the most common forms of analgesia used for postcesarean analgesia. It is associated with bothersome side effects of pruritus and nausea/vomiting, however. The rectus sheath block has been found to decrease opioid requirements after many types of surgeries, including cesarean delivery without intrathecal morphine. This study sought to determine the efficacy and side-effects of intrathecal morphine, rectus sheath block with bupivacaine, and their combination for women undergoing elective cesarean deliveries.