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Background: Although intraspinal morphine has been shown to be effective in providing analgesia after cesarean delivery, pruritus as a side-effect remains a common cause of dissatisfaction. The role of ondansetron has been studied in preventing pruritus but the results have been contradictory. Methods: We randomized 98 parturients undergoing elective cesarean section using combined spinal-epidural anesthesia into a double-blinded trial to receive tropisetron 5 mg (T group) or ondansetron 8 mg (O group) or placebo (NaCl group) after delivery, when intrathecal morphine 160 mg and fentanyl 15 mg were used for post-operative pain control. The patients additionally received ketoprofen 300 mg per day. Postoperative itching, nausea and vomiting, sedation and need for rescue analgesics were registered every 3 h up to 24 h, and all patients were interviewed on the first post-operative day. Results: Seventy-six percent of the parturients in the placebo group, 87% in the ondansetron, and 79% in the tropisetron group had itching. The incidence of post-operative nausea and

The incidence of persistent pain at 1 year is greater after cesarean delivery than after vaginal delivery. Pain shortly after cesarean delivery and during vaginal delivery correlated with persistent pain.

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(Anesth Analg. 2016;123(6):1535–1545) Persistent pain after cesarean delivery has been associated with recall of acute pain and history of chronic pain. In an earlier retrospective study, the authors found that the incidence of persistent pain at 1 year after cesarean delivery was 18%, compared with 10% at vaginal delivery (P=0.011). To confirm these findings, the authors evaluated the intensity and characteristics of persistent pain and its association with previous pain and other obstetric factors in this prospective study.