Document Type
Article
Department
Anaesthesia; Centre for Innovation in Medical Education
Abstract
Background:Management of postoperative pain after caesarean section (CS) requires a balance between pain relief and undesirable side effects of drugs and technique. In order to improve postoperative pain management after caesarean section, we compared intravenous patient controlled analgesia (IV-PCA) with our current hospital practice, which is continuous opioid infusion.
Method: We enrolled one hundred and twenty patients in our prospective randomized trial after an uneventful elective caesarean section under spinal anaesthesia. All patients received 0.5 mg/kg bolus of pethidine on first complaint of pain or at 120 minutes after institution of spinal anaesthesia. Depending upon the ran-domization, Group P received IV-PCA with 0.15 mg/kg bolus pethidine with 10-minute lockout and Group C received continuous pethidine infusion at a rate of 0.15 mg/kg/hr.
Statistical Analysis: For qualitative variables means and stan-dard deviations were computed and analyzed by T-test, Mann Whitney U test and repeated measures ANOVA. Fre-quency and percentages were computed for qualitative data and analyzed by Chi-Square and Fischer exact test. A p-value of less than 0.05 was treated as significant.
Results: The numeric rating score for pain, need for rescue analge-sia and incidence of nausea and vomiting was significantly lower (p-value < 0.001) in IV-PCA group as compared to continuous infusion group at 6, 12 and 24 hours postoperatively, 98% of the patients were satisfied with pain manage-ment in Group P as compared to 70% (p < 0.001) in Group C.
Conclusion: Our results showed improved pain control, less need for rescue analgesia for breakthrough pain, lower incidence of nausea and vomiting and greater patient satis-faction with IV-PCA. In the absence of preservative free narcotics for intrathecal use, postoperative pain management can be significantly improved by using IV-PCA instead of continuous opioid infusion in patients undergoing caesarean section.
Publication (Name of Journal)
Open Journal of Anesthesiology
Recommended Citation
Ismail, S.,
Afshan, G.,
Monem, A.,
Ahmed, A.
(2012). Postoperative Analgesia Following Caesarean Section: Intravenous Patient Controlled Analgesia versus Conventional Continuous Infusion. Open Journal of Anesthesiology, 2(4), 120-126.
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_anaesth/76