CS without morphine?

[AmandinePoulain]

I'm booked in for an elective CS in just over 5 weeks time, due to a previous traumatic delivery resulting in CS, plus my baby is breech. Following my last section I had unbearable itching for several hours afterwards, I'm assuming to the morphine which was added to the spinal. I've just been seen in anaesthetic clinic and requested that I didn't have morphine this time, so it's been agreed that I'll be given just fentanyl with the local anaesthetic - but the anaesthetist seemed concerned that I wouldn't receive adequate pain relief this way, and that when the anaesthetic wears off I'll be in a lot of pain. I didn't have a PCA last time, I was given regular codeine and diclofenac, which worked well, I stopped taking the codeine after a few days and the diclofenac after about a week.

Does anyone have any experience of a CS without any morphine? I wasn't worried until she seemed concerned, please reassure me that I won't be in agony! (I really would rather avoid the morphine - the itching was horrendous)

Thanks

I'm now, not very helpfully, allergic to codeine and paracetamol. I've been told if I ever need strong pain killers eg morphine they'll be able to keep the allergic reaction (anaphalactic shock) under control with steriods as its not as bad as the paracetamol one. So perhaps you could ask if there's any other way round the morphine issue that they could suggest for you to consider?

I wasn't given any morphine after my 2nd CS, just diclofenac and paracetemol.

It was rubbish, I was in pain most of the time. I thought it was something to do with cost cutting.

1st section, I had morphine for 24 hrs after baby born and it was great. I then had diclofenac.

I would speak to the anaesthetist again.Perhaps they can give you something for the itching instead?

She said that I could have piriton if it happens again, but that piriton isn't very effective in that situation so it probably wouldn't be a good solution. Otherwise I could have naxalone if I itch - which would immediately 'wipe out' any opiates in my system - so it would also reverse the fentanyl and any codeine I'd had - so yes I'd stop itching but I'd have no pain relief on board at all, and suddenly, so that's not a great solution either!

I didn't have morphine after my first or third CS, was absolutely fine, really not a problem at all, wasn't in any great pain.

Had diclofenac and paracetamol afterwards.

Have you asked if they could give it to you as an injection on the ward if you are struggling with the pain, my local hospital does this.

I thought about that, that'll probably be the best solution. I was fairly numb for several hours afterwards last time, I really wasn't worried until she said that. Plenty of people must be allergic to morphine though, they must have come across this situation before? I'll be seeing the anaesthetist that'll be with me in theatre a few days before (she's told me it won't be her) so I can go through it all again with them.

Thanks for all the replies.

I had cs last August and had no morphine. I was fine on just codiene, paracetamol and ibruprofen until day 5 when mw told me I shouldn't need pain relief anymore! Errr I was lifting two babies who were in special care every 2 hours and got up 6 hours after cs so wasn't being dramatic. I was however rather surprised others seem to get morphine. I do believe that if I hadn't had twins to deal with (standing changing 2 lots of nappies and not being at home so dh couldn't help as he couldn't be at hospital all the time) it wouldn't have been an issue at all. I healed well and all was fab xx

It is usually the fentanyl that makes you itch, not the morphine!

Itching is a common side effect with fentanyl, which is why many women though less severe than the itching with morphine. Many women have cs without morphine. Many women have emus with just epidural and no morphine on board and do fine post op without morphine.
Best of luck for the birth

The morphine (or more commonly diamorphine) actually goes into the spinal injection. It tends to give pain relief for about 12 hours after the operation which is why most people only need paracetamol and diclofenac post operatively. If there is no morphine in the spinal injection then morphine will almost certainly need to be given post op.

I had general anesthesia for my first section with twins, I was in lot of pain when I woke up. But I had spinal with morphine for second c-s, had some itching on my face, but I tell you it was heaven compared to my first.

Jolly that's interesting. I had emcs under ga too and there's no way I'd have got through the first 48 hours of recovery without morphine. I think I have a relatively high pain threshold too - got to 10cms in labour and refused to believe it .

Sorry, twins here too. Wonder if it's the ga or twins factor that makes recovery harder until lovely lovely morphine made it all better

I had the same issue with itching - I only had morphine in the spinal & managed with diclofenac suppository then codeine & paracetamol afterwards - with my 2nd & 3rd sections. The itching was so bad with my 3rd that they only put a tiny dose into the spinal during my 4th section. The post operative pain was considerably worse ... I ended up needing oromorph (which didn't make me itch but didn't touch the pain either) then tramadol which was marvellous but I was off my face after it. Pain was preferable to itching though, with hindsight.

I thought I'd come back and update in case anyone is in a similar position.

Dd2 decided that she didn't want to wait until the 20th to make her appearance and I went into labour on Thursday night. After a scan showed that she wasn't breech after all (she just has a very bony bum ) I declined the VBAC I was offered and had an EMCS. The lovely anaesthetist strongly encouraged me to rethink on the morphine, he didn't feel that I'd be comfortable without it so I consented to it, as well as fentanyl, being added to the spinal.
Post op I was comfortable, and needed codeine and ibuprofen once the spinal wore off. I did have itching - much less severe than last time but it lasted for 2 days. I'm glad that he was firm with me and told me what to do, I think it was what I needed!

Thanks to everyone who replied to this thread