Development and Implementation of a Ready-to-Use Intrathecal Mixture of Hyperbaric Bupivacaine and Morphine for Cesarean Delivery

Br J Anaesth. 2026; 136:1068–1070. doi: 10.1016/j.bja.2025.12.019 Worldwide, ~20% of births occur via cesarean delivery (CD), a procedure frequently associated with considerable postoperative pain. Effective analgesia is crucial for maternal recovery, early mobilization, and successful initiation of breastfeeding. International guidelines recommend long-acting neuraxial opioids as first-line therapy for pain management after CD. Although both morphine and diamorphine are acceptable agents, diamorphine is not widely available outside the United Kingdom. Despite strong evidence supporting the safety and efficacy of intrathecal opioids, their use varies significantly across countries.