INTEREST OF ANTIDOTE TO PAINKILLERS IN THE TREATMENT OF THE SIDE EFFECTS OF MORPHINE ADMINISTERED AS AN ADJUVANT IN SPINAL ANESTHESIA

Objective: Appreciate the effectiveness of antidote to pain killers in the treatment of the side effects of morphine administered intrathecally and its impact on post-operative pain. Patients and method: The study was a prospective, randomized, single-blind "case - control" study that took place over 1year (November 1, 2021 - December 1, 2022). It focused on cesarean patients under spinal anesthesia. Were included: parturient ASA 1 and 2 eligible for a cesarean section under spinal anesthesia and having a size greater than 150 cm. All patients benefited from the same anesthetic protocol. The "case" population received 40 µg of naloxone systematically on IVD at the end of the intervention (M0). This dose was repeated only once in the sixtieth minute (M60) in the presence of adverse effects. Side effects were researched and the level of pain assessed during the first 24 hours after cesarean. The socio demographic, clinical parameters, the side effects of morphine, post-operative pain as well as patient satisfaction were studied. Results: 200patients were selected. 100 received naloxone and the other 100 were controls. Their average age was 25.8 years. There was a regression of pruritus (p = 0.001) without significant change in analgesia in the population who received naloxone. There was no significant difference in the occurrence of postoperative nausea and vomiting (p > 0.05). The "case" patients were more satisfied with the anesthetic protocol than the "Control" patients (p = 0.0023). Conclusion: Naloxone could improve the comfort of patients receiving spinal anesthesia using morphine as an adjuvant. Keywords: Spinal anesthesia, naloxone, side effects of morphine.