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Background: Increased attention to improving the provision of analgesia has led to increased use of pain measurement systems, including visual analogue scales, which have not been validated for use in clinical care. The reliability of visual analog scale (VAS) scores has not been demonstrated in the acute setting where pain fluctuation might be greater than for chronic pain. Methods:This was a prospective observational study, consisting of females after caesarean section. 108 (ASA I &II) patients operated for caesarean section were evaluated for postoperative pain by VAS and their desire for medications. Caesarean section was done under regional anaesthesia with 0.5% Bupivicaine with no opioid intrathecal adjuncts due to the non availability in a small hospital setting in rural India. Four patient factors were studied and their correlation with VAS was observed. A VAS of 5 at rest and 8 on induced cough was taken as an indicator of significant pain and rescue analgesic was administered at this point. The patient factors studied were education level (high school vs college), age of patients (Ͻ35; Ͼ 35), duration of labour prior to delivery (Ͼ12 hours; Ͻ 12 hours) and sex of the newborn (male vs female).The factors chosen were a mix of local clinical, psychological and social aspects involved with the child birth. Results:The time taken for first pain and time taken from first pain to significant pain was noted. Both the parameters were delayed in patients who were more educated and who had female babies born to them. Both the parameters were delayed in patients who had prolonged labours. Age of the patient did not show any statistically significant difference in time scale for reaching the significant VAS scores. Conclusion:Visual Analogue Scale has some practical limitations in a clinical setting and cannot adequately assess the requirement for analgesia.187. Postoperative pain management following caesarean section: quality evaluation of two protocols Background and Aims: Postoperative pain management has a humanitarian role, but medical and economic benefits are also important. The objective of this study was to evaluate the quality of two protocols used in our institution for the management of postoperative pain following caesarean section. Methods:We conducted a retrospective analysis of the registers of the protocols used for the management of postoperative pain following caesarean section during the year 2006. Several factors were considered relating to the effectiveness (degree of pain according to Numerical Rating Scale [NRS]), safety (hypotension) and tolerability (vomiting, excessive sedation, pruritis and urinary retention) of the protocols. The values considered were the worst ones found during the first 48 hours of therapy.Results: 557 patients were analysed and their age was 28,5 Ϯ 5,9 years. 28% of them were treated with a protocol based on Intravenous therapy (IVt) (Tramadol 100mg iv 6/6 hours ϩ Paracetamol 1g iv 6/6 hours) and 72% with a protocol based on Epidural therapy (EPt) (Morfine 2 mg epid...