ESRA19-0631 Efficacy of pain control following scheduled cesarean delivery under intrathecal anaesthesia, and the need for opioid use in the first 24 hours. (30th August 2019)

• Record Type: Journal Article
• Authors: Singh, V; Lal, S; Thomas, J; Narayanan, N; Malik, A
• Is Part Of: Regional anesthesia and pain medicine. Volume 44(2019)Supplement 1
• Page Start: A273
• Page End: A273
• Publication Date: 2019-08-30
• Subjects: Conduction anesthesia -- Periodicals; Pain medicine -- Periodicals; 617.964
• DOI: 10.1136/rapm-2019-ESRAABS2019.499
• Languages: English
• ISSNs: 1098-7339

Abstract

Abstract : Background and aims: Pain management following cesarean section has always been a very debatable concern. Postpartum women with pain restrict their mobility, which undermines breastfeeding. Multiple modes for managing post-op pain are established. However, among the most commonly used techniques, intrathecal opioids with local anaesthetics are recognised as a gold standard. It has been observed that morphine can provide post-operative analgesia for up to 24 hours, and a dose of up to 100 mcg is relatively safe in patients undergoing cesarean section. Methods: A prospective audit was conducted over 6 weeks in Our Lady of Lourdes Hospital, Drogheda. We included all patients who had cesarean section (elective/emergency) during that time under spinal anaesthesia after receiving approval from the local committee. Data was collected by reviewing patients' charts after 24-hour post-spinal anaesthesia. Results: Total of 50 patients included. 72% of patients needed opioid in the first 24 hours. Compliance with regular paracetamol 100% and NSAIDS 90%. Conclusions: In our audit, we found patients undergoing caesarean section with intrathecal opioids still required oral opioids within the first 24 hours. No significant side effect was noted. It is recommended to prescribe oral opioids PRN in the postoperative period along with paracetamol, NSAIDs (if no contraindication), antiemetics and antipruritic drugs.