Intrathecal Opioid Study

• To evaluate the effect of three different intrathecal opioid mixtures on post-operative pain experiences in women who have undergone caesarean section surgery, relating specifically to:

• Post-operative analgesic requirements at two time points (12 hours and 24 hours) after surgery
• Pain scores at two time points (12 hours and 24 hours) after surgery
• Sedation scores at two time points (12 hours and 24 hours) after surgery
• Post-operative nausea scores at two time points (12 hours and 24 hours) after surgery
• Post-operative pruritis scores at two time points (12 hours and 24 hours) after surgery
• To determine the impact that the patients' post-operative pain has on their activities in the first 24 hours after surgery

Inclusion criteria

• All patients > 18years having caesarean section surgery under single shot spinal neuraxial anaesthesia at Rahima Moosa Mother and Child Hospital

Exclusion criteria

• Pre-operative:

b) Patient refusal or inability to give informed consent c) Severe pre-eclampsia d) Eclampsia e) Patient unable to understand how to use the Patient Controlled Analgesia (PCA) pump, after appropriate counselling and training

• Intra-operative:

a) Obstetric Complications: i) Post-partum Haemorrhage ii) Ruptured Uterus iii) Still Birth b) Conversion to general anaesthesia intra-operatively c) Administration of supplementary intravenous opioid analgesics

• Post-operative:

• Patients who have babies that require additional care, for a prolonged period, after birth eg. Neonatal ICU admission for ≥ 12hours or congenital abnormalities
• Patients who require ICU or High care admission postoperatively for any intra-operative complications