Subcutaneous Bupivacaine Decrease Post-op Pain in Patients Undergoing C-Section
Condition: Pain, Referred
MeSH terms: Pain, Referred
Intervention: Bupivacaine; Morphine; Fentanyl; Epinephrine; Saline solution
Intervention description: 20 ml subcutaneous bupivacaine (Marcaine) 0.25%. Bupivacaine is an anesthetic which can numb an area of the body to relieve pain during surgery or medical procedures, childbirth, and dental work.; intrathecal morphine (Duramorph) 150mcg. DURAMORPH (morphine injection) is a systemic narcotic analgesic for administration by the intravenous, epidural or intrathecal routes. It is used for the management of pain not responsive to non-narcotic analgesics. DURAMORPH (morphine injection) administered epidurally or intrathecally, provides pain relief for extended periods without attendant loss of motor, sensory or sympathetic function.; intrathecal fentanyl 10 mcg. Fentanyl (also spelled fentanil) is an opioid which is used as a pain medication and together with other medications for anesthesia.; Epinephrine injection is used along with emergency medical treatment to treat life-threatening allergic reactions caused by insect bites or stings, foods, medications, latex, and other causes. Epinephrine is in a class of medications called alpha- and beta-adrenergic agonists (sympathomimetic agents). It works by relaxing the muscles in the airways and tightening the blood vessels.; 20 ml subcutaneous NACL 0.9% - saline solution is the placebo
Intervention MeSH terms: Epinephrine; Fentanyl; Morphine; Bupivacaine
Phase: Phase 2
Study type: Interventional
Primary purpose: Supportive Care
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Enrollment: 26.0
Sex: Female
Minimum age: 17 Years
Maximum age: 40 Years
Healthy volunteers: Accepts Healthy Volunteers

Summary:

      The purpose of this study is to determine if giving an injection of numbing medication at the
      incision at the end of cesarean will help control pain AFTER cesarean delivery. This study
      seeks to assess pain relief with incisional infiltration of local anesthetic during cesareans
      performed under spinal anesthesia also using intrathecal opioids. Participants will receive
      the usual regimen of pain medication in spinal anesthesia. At the end of the cesarean
      delivery, while the participants are still under the spinal medication, participants will
      receive an injection, at the incision, either numbing medication (with or without
      epinephrine) or sterile saline. After the cesarean delivery, participants will receive, by
      mouth, commonly prescribed pain medications - these medications are oxycodone (an opioid/
      narcotic), acetaminophen (or more commonly known as Tylenol), and ibuprofen.
    

Eligibility criteria:

        Inclusion criteria:

          -  elective cesarean delivery

          -  planned spinal anesthesia

        Exclusion criteria:

          -  Non-English speaking

          -  Urgent or emergent cesarean delivery

          -  Active labor [defined as: >4cm cervical dilation or regular contractions noted on
             tocometer (>2 contractions in a 10 minute period for 30 consecutive minutes)]

          -  Chronic antepartum opioid use

          -  History of substance abuse (alcohol or drug)

          -  Current tobacco use

          -  Chronic steroid use