Research in Focus shines a light on the innovative studies and discoveries taking shape across the UBC Department of Anesthesiology, Pharmacology & Therapeutics. Through each feature, we celebrate the minds driving meaningful change in research, education, and clinical practice across anesthesiology, pharmacology, and therapeutics.
For Dr. Ilana Sebbag, improving the safety and experience of childbirth through evidence is both a clinical responsibility and a research calling. Most recently, her contributions to a recent trial that determined hydromorphone is noninferior to morphine for post-cesarean analgesia is helping translate clinical evidence into safer maternal care.
Her work centers on advancing evidence-based obstetric anesthesia, with a particular emphasis on maternal–fetal health, neuraxial techniques, and perioperative recovery.
Dr. Sebbag has led and collaborated on randomized trials and observational studies evaluating intrathecal opioid strategies, quality of recovery after cesarean delivery, and predictors of post-cesarean pain. Her research also explores the optimization of neuraxial ultrasound, patient positioning, and procedural techniques to enhance both safety and patient experience.
In parallel, she has contributed to national and international guidelines on hypertensive disorders of pregnancy and anesthesia care, helping translate evolving evidence into clinical practice and ensuring that research meaningfully informs care at the bedside.
In her latest work, Intrathecal Hydromorphone Versus Intrathecal Morphine for Postcesarean Delivery Analgesia: A Randomized Noninferiority Trial Dr. Sebbag and her team determined that hydromorphone is noninferior to morphine for postcesarean delivery analgesia.
“In clinical settings where morphine is unavailable or subject to supply constraints, hydromorphone represents a safe, effective, and appropriate alternative for intrathecal use in cesarean delivery. ”
— Ilana Sebbag, Clinical Associate Professor, UBC
Meet Ilana Sebbag!
Site: BC Women’s Hospital
Rank: Clinical Associate Professor
Ilana Sebbag began her medical training at the University of São Paulo, where she earned her MD and completed her residency in Anesthesiology. Early on, she embraced leadership, serving not only as an anesthesiologist and ACLS instructor, but also as a military physician in the Brazilian Air Force. These formative roles instilled in her a deep sense of responsibility, precision, and service.
Motivated by a growing commitment to maternal health, Dr. Sebbag pursued subspecialty fellowship training in Obstetric and Regional Anesthesia at the University of British Columbia. It was there that her academic focus in obstetric anesthesia truly took shape. She went on to build her academic career at Western University before returning to UBC, where she continues to integrate clinical excellence with research leadership and medical education. Strengthened by graduate training in Clinical Epidemiology and Biostatistics, her work reflects a thoughtful commitment to advancing evidence-based care for mothers and families.
What drew you to this particular research question or problem?
I chose to compare these two medications primarily due to concerns regarding supply chain vulnerability. Drugs such as morphine, which are off patent and generate limited profit, are often manufactured by a small number of producers globally, rendering them particularly susceptible to shortages.
In Canada, for instance, there have been three shortages of injectable morphine within the past year, including preservative-free morphine—the formulation commonly used for intrathecal administration.
From a pharmacologic perspective, hydromorphone is a compelling alternative. It is both more potent and more lipophilic than morphine, characteristics that facilitate more rapid diffusion through the cerebrospinal fluid and likely contribute to a faster onset of action.
Additionally, hydromorphone exhibits greater affinity for the μ-opioid receptor, a property that may enhance its effectiveness in opioid-tolerant patients.
What’s one thing you hope people will take away from this study?
The principal objective of a non-inferiority study is to demonstrate that an alternative intervention is not clinically worse than the established standard of care. Our findings support this objective.
Hydromorphone provided analgesia equivalent to that of morphine, without an associated increase in adverse effects or complications.
Accordingly, in clinical settings where morphine is unavailable or subject to supply constraints, hydromorphone represents a safe, effective, and appropriate alternative for intrathecal use in cesarean delivery.
Outside of work, what do you enjoy the most?
Outside of work, I most enjoy most spending time with my children and being present for the everyday moments with them. I also value staying active through movement and fitness, and I enjoy exploring wellness practices that support long-term health. Cooking and baking are creative outlets for me, and I appreciate opportunities to connect with friends and family.
Read the full publication: Intrathecal Hydromorphone Versus Intrathecal Morphine for Postcesarean Delivery Analgesia: A Randomized Noninferiority Trial
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