Women diagnosed with stages I, II and III cervical cancer are treated with chemo-radiation (pelvic external-beam radiation, weekly cisplatin chemotherapy and HDR cervical brachytherapy).

Patients are given anaesthesia during the inpatient brachytherapy procedure that lasts 1 day. In our institution, morphine is used as the intrathecal anaesthetic for pain relief in these patients.

Patients who give informed consent will be recruited for this study. 

As per routine practice, spinal anaesthesia with intrathecal morphine will be given as analgesic for brachytherapy. 

Patients will be monitored for hemodynamic variables like Heart rate, Blood pressure, Oxygen saturation( SpO2 ) throughout the procedure and also in the recovery room.

Patients will be assessed for i)Nausea and vomiting, ii)need for anti emetics, iii) pain score, iv)need for rescue analgesia,v)sedation score, vi)pruritus and respiratory depression in the recovery room as well as in the

postoperative ward.

Nausea and vomiting will be assessed by nausea vomiting score (0 = No nausea , 1 = Nausea, 2 = Retching, 3=Vomiting)

Pain will be assessed by visual analogue scale ( VAS : 0 to 10 scale in which 0 = no pain, 10 = maximum pain).

Sedation will be assessed by Ramsay sedation score (RSS: 1=Anxious, agitated, restless, 2= Co operative, oriented, tranquil, 3=Responds to command only, 4 = Asleep, brisk response to stimulus,5 = Asleep, sluggish response to stimulus, 6 = Un arousable).

A respiratory rate of < 8 breaths/minute and oxygen saturation of <92% will be taken as respiratory depression

The total dose of opioids administered, the first time of rescue analgesic administered, antiemetics given will be noted and analysed.

The study hypothesis is that intrathecal morphine is a good analgesic with no side effects in patients undergoing Brachytherapy.