Post-caesarean analgesia: What is new?

Kerai, Sukhyanti; Saxena, Kirti N; Taneja, Bharti

doi:10.4103/ija.ija_313_16

Cited by 58 publications

(32 citation statements)

References 57 publications

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“…Recently, there has been increased used of other analgesic modalities following caesarean delivery. 23 – 25 TAP block has been advocated recently. 23 , 24 A previous study compared multimodal analgesia similar to this current study with TAP and found less need for opioids and better VAS scores.…”

Section: Discussionmentioning

confidence: 99%

“… 23 – 25 TAP block has been advocated recently. 23 , 24 A previous study compared multimodal analgesia similar to this current study with TAP and found less need for opioids and better VAS scores. 31 Other studies have shown more beneficial effects of TAP compared with opioids and NSAIDs when used alone or in combination.…”

Section: Discussionmentioning

confidence: 99%

“…[20][21][22] Recently, there has been newer techniques of trying to achieve optimum analgesia after caesarean deliveries. [23][24][25] All of these techniques aim to provide a pain-free caesarean delivery. These modalities include transversus abdominis plane (TAP) block, ilioinguinal-iliohypogastric (IL-IH) nerve block, wound infiltration/infusion, ketamine and the use of gabapentin.…”

Section: Introductionmentioning

confidence: 99%

“…These modalities include transversus abdominis plane (TAP) block, ilioinguinal-iliohypogastric (IL-IH) nerve block, wound infiltration/infusion, ketamine and the use of gabapentin. 23 , 24 All of these newer techniques have been developed to reduce the dose of opioids required after caesarean delivery. However, most of these newer non-opioid techniques are not readily available in public hospitals in our environment.…”

Section: Introductionmentioning

confidence: 99%

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Pentazocine with rectal diclofenac versus pentazocine alone for pain relief following caesarean delivery in Enugu, Nigeria: A randomized controlled trial

et al. 2022

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Objective To measure postoperative pain relief following the use of rectal diclofenac combined with intramuscular pentazocine compared with intramuscular pentazocine alone in patients undergoing a caesarean delivery. Methods This single-blind randomized controlled trial enrolled pregnant women that had a caesarean section at the Enugu State University of Science and Technology Teaching Hospital, Enugu, Nigeria. Study participants were randomized to receive either 100 mg of rectal diclofenac given every 12 h plus 30 mg of intramuscular pentazocine given every 6 h (group A) or 60 mg of intramuscular pentazocine given every 6 h (group B). The primary outcome was the level of pain as measured using a visual analogue scale. The secondary outcomes were the level of satisfaction with pain relief and need for rescue analgesia. Results A total of 200 participants were randomized equally into the two groups. Participants in group A had significantly better pain control and satisfaction over the 48 h after surgery compared with group B. Significantly more of group B required rescue analgesia for breakthrough pain compared with group A. Conclusion Rectal diclofenac combined with intramuscular pentazocine was significantly better at controlling pain compared with pentazocine alone in the first 48 h following caesarean section. Trial registration number: PACTR202107706925314 at www.pactr.org on 28 July 2021.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pentazocine with rectal diclofenac versus pentazocine alone for pain relief following caesarean delivery in Enugu, Nigeria: A randomized controlled trial

et al. 2022

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“…Pain after cesarean section is usually ranked moderate to severe. 1 Management of pain after birth is important and can impact a woman’s return to normal activities and caring for her baby and shorten lactogenesis. 2 Traditionally, intravenous administration of opioids has been successfully used for pain control after cesarean section.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Patient-Controlled Intravenous Analgesia (PCIA) with Sufentanil Background Infusion for Post-Cesarean Analgesia: A Randomized Controlled Trial

Nie¹,

Cui²,

Zhang³

et al. 2022

JPR

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Purpose To investigate the effectiveness of sufentanil patient-controlled intravenous analgesia pump (PCIA) and background infusion in patients of post-cesarean analgesia. Patients and Methods This trial compared two groups of women undergoing cesarean section and receiving PCIA: no background infusion group (n=30), 6-min lockout time, and background infusion group (n=30), 2 mL/h infusion, 10-min lockout time. Both groups with 2 μg/kg sufentanil was diluted to 100 mL with normal saline. VAS scores at rest at 36 h was the primary endpoint. The secondary endpoints were the VAS scores at rest at 6, 12, and 24 h, the total amount of sufentanil consumed, the Ramsay sedation score (RSS) assessed at the same time points, postpartum bleeding within 24 h, the injection/attempt (I/A) ratio, BP and HR, PONV, side effects of sufentanil. Results Compared with the no background infusion group, the background infusion group showed lower VAS pain scores at 6, 12, and 24 h (P<0.01), but no differences at 36 h (95% CI = −0.5–0.8. P>0.05). Attempts, injections, and total sufentanil consumption were significantly different between the two groups (P<0.001), but without difference in I/A. Bleeding was less in the background infusion group at 1 h (P=0.03). The minimal respiration rates were not significantly different between groups. Conclusion Background infusion increased the total consumption of sufentanil within 36 h after cesarean section. Although it did not reduce uterine contraction pain and wound pain at 36 h, it significantly reduced the pain at 6, 12, and 24 h after cesarean section. It improved patient satisfaction and reduced the amount of bleeding after 1 h. Importantly, it did not increase the incidence of hypertension, PONV and respiratory depression.

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Oral versus patient-controlled intravenous administration of oxycodone for pain relief after cesarean section

Mäkelä

Palomäki

Pokkinen

et al. 2019

Arch Gynecol Obstet

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PurposeThe optimal postoperative analgesia after cesarean section (CS) remains to be determined. The primary objective of this study was to assess whether oral oxycodone provides the same or better pain control and satisfaction with pain relief as oxycodone given intravenously using a patient-controlled analgesia (PCA) infusion device. The secondary objectives were to compare the gastrointestinal symptoms and postsurgical recovery of the two groups.MethodsThis prospective randomized trial was conducted at a University Hospital between February 2015 and June 2017. Altogether 270 CS patients were randomly assigned to receive postoperative oxycodone pain relief by IV PCA (n = 133) or orally (n = 137). Pain control and satisfaction with pain treatment were assessed by a numeric rating scale (NRS) at 2, 4, 8, and 24 h postoperatively.ResultsNo differences were found in NRS pain scores or satisfaction between the groups except at 24 h pain when coughing; there was a statistically significant difference favoring the IV PCA group (p = 0.006). In the IV PCA group, the patients experienced more nausea at 4 h (p = 0.001) and more vomiting at 8 h (p = 0.010). Otherwise, postoperative recovery was similar in both groups. The equianalgesic dose of oxycodone was significantly smaller in the oral group (p = 0.003).ConclusionsThis study indicates that oral oxycodone provides pain control and satisfaction with pain relief equal to IV oxycodone PCA for postoperative analgesia after cesarean section. Satisfaction with pain treatment was high in both groups, and both methods were well tolerated. Early nausea was less common with oral medication.

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Post-caesarean analgesia: What is new?

Cited by 58 publications

References 57 publications

Pentazocine with rectal diclofenac versus pentazocine alone for pain relief following caesarean delivery in Enugu, Nigeria: A randomized controlled trial

Pentazocine with rectal diclofenac versus pentazocine alone for pain relief following caesarean delivery in Enugu, Nigeria: A randomized controlled trial

Effectiveness of Patient-Controlled Intravenous Analgesia (PCIA) with Sufentanil Background Infusion for Post-Cesarean Analgesia: A Randomized Controlled Trial

Oral versus patient-controlled intravenous administration of oxycodone for pain relief after cesarean section

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