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Pain Relief After Caesarean Delivery

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Quick Hits in Obstetric Anesthesia

Abstract

Caesarean delivery is associated with moderate to severe postoperative pain, comparable to the pain after abdominal hysterectomy [1]. Post caesarean pain affects the mother’s functional capacity during recovery from surgery and taking care of her newborn. It is the most important concern of expectant mothers undergoing caesarean delivery and therefore effective post-operative pain management should aim for visual analogue pain (VAPS) scores of below 3 (on a scale of 0–10) both at rest and on movement [2].

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References

  1. Fassoulaki A, Gatzou V, Petropoulos G, Siafaka I. Spread of subarachnoid block, intraoperative local anaesthetic requirements and postoperative analgesic requirements in caesarean section and total abdominal hysterectomy. Br J Anaesth. 2004;93(5):678–82.

    Article  CAS  Google Scholar 

  2. Carvalho B, Cohen SE, Lipman SS, Fuller A, Mathusamy AD, Macario A. Patient preferences for anesthesia outcomes associated with cesarean delivery. Anesth Analg. 2005;101:1182–7.

    Article  CAS  Google Scholar 

  3. Juying J, Lihua P, Qibin C, Dong Z, Li R, Peipei Q, Su M. Prevalence and risk factors for chronic pain following cesarean section: a prospective study. BMC Anesthesiol. 2016;16:99. https://doi.org/10.1186/s12871-016-0270-6.

  4. Komatsu R, Carvalho B, Flood PD. Recovery after nulliparous birth: a detailed analysis of pain analgesia and recovery of function. Anesthesiology. 2017;127(4):684–94.

    Google Scholar 

  5. Dahl JB, Jeppesen IS, Jorgensen H, Wetterslev J, Moiniche S. Intraoperative and postoperative analgesic efficacy and adverse effects of intrathecal opioids in patients undergoing cesarean section with spinal anesthesia: a qualitative and quantitative systematic review of randomized controlled trials. Anesthesiology. 1999;91:1919–27.

    Article  CAS  Google Scholar 

  6. Hallworth SP, Fernando R, Bell R, Parry MG, Lim GH. Comparison of intrathecal and epidural diamorphine for elective cesarean section using a combined spinal epidural technique. Br J Anaesth. 1999;82(2):228–32.

    Article  CAS  Google Scholar 

  7. Carvalho B, Riley E, Cohen SE, Gambling D, Palmer C, Huffnagle H, Polley L, Muir H, Segal S, Lihou C, Manvelian G. Single-dose, extended-release epidural morphine (DepoDur) compared to conventional epidural morphine for post-cesarean pain. Anesth Analg. 2005;100:1150–8.

    Article  CAS  Google Scholar 

  8. Bonnet MP, Marret E, Josserand J, Mercier FJ. Effect of prophylactic 5-HT3 receptor antagonists on pruritus induced by neuraxial opioids: a quantitative systematic review. Br J Anaesth. 2008;101:311–9.

    Article  CAS  Google Scholar 

  9. McNicol ED, Ferguson MC, Hudcova J. Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain. Cochrane Database Syst Rev. 2015 Jun 2;(6):CD003348.

    Google Scholar 

  10. Bonnal A, Dehon A, Nagot N, Macioce V, Nogue E, Morau E. Patient-controlled oral analgesia versus nurse-controlled parenteral analgesia after caesarean section: a randomised controlled trial. Anesthesia. 2016;71(5):535–43.

    Article  CAS  Google Scholar 

  11. Mkontwana N, Novikova N. Oral analgesia for relieving post-caesarean pain. Cochrane Database Syst Rev. 2015 March 29;(3):CD010450.

    Google Scholar 

  12. Koren G, Cairns J, Chitayat D, Gaedigk A, Leeder SJ. Pharmacogenetics of morphine poisoning in a breastfed neonate of a codeine-prescribed mother. Lancet. 2006;368:704.

    Article  Google Scholar 

  13. McDonnell NJ, Paech MJ, Browning RM, Nathan EA. A randomised comparison of regular oral oxycodone and intrathecal morphine for post-caesarean analgesia. Int J Obstet Anesth. 2010;19(1):16–23.

    Article  CAS  Google Scholar 

  14. Pavy TJ, Paech MJ, Evans SF. The effect of intravenous ketorolac on opioid requirement and pain after cesarean delivery. Anesth Analg. 2001;92(4):1010–4.

    Article  CAS  Google Scholar 

  15. Matsota P, Nakou M, Kalimeris K, Batistaki C, Pandazi A, Kostopanagiotou G. A single dose of celecoxib 200 mg improves postoperative analgesia provided via patient-controlled epidural technique after caesarean section. Arch Med Sci. 2013;9(5):877–82.

    Google Scholar 

  16. Fong WP, Yang LC, Wu JI, Chen HS, Tan PH. Does celecoxib have pre-emptive analgesic effect after caesarean section surgery? Br J Anaesth. 2008;100(6):861–2.

    Article  Google Scholar 

  17. Remy C, Marret E, Bonnet F. Effects of acetaminophen on morphine side-effects and consumption after major surgery: meta-analysis of randomized controlled trials. Br J Anaesth. 2005;94:505–13.

    Article  CAS  Google Scholar 

  18. Ho KY, Gan TJ, Habib AS. Gabapentin and postoperative pain—a systematic review of randomized controlled trials. Pain. 2006;126:91–101.

    Article  CAS  Google Scholar 

  19. Zhang J, Ho KY, Wang Y. Efficacy of pregabalin in acute postoperative pain: a meta-analysis. Br J Anaesth. 2011;106(4):454–62.

    Article  CAS  Google Scholar 

  20. Moore A, Costello J, Wieczorek P, Shah V, Taddio A, Carvalho JC. Gabapentin improves postcesarean delivery pain management: a randomized, placebo-controlled trial. Anesth Analg. 2011;112(1):167–73.

    Article  CAS  Google Scholar 

  21. Monks DT, Hoppe DW, Downey K, Shah V, Bernstein P, Carvalho JC. A perioperative course of gabapentin does not produce a clinically meaningful improvement in analgesia after cesarean delivery: a randomized controlled trial. Anesthesiology. 2015;123(2):320–6.

    Article  CAS  Google Scholar 

  22. Bauchat JR, Higgins N, Wojciechowski KG, McCarthy RJ, Toledo P, Wong CA. Low-dose ketamine with multimodal postcesarean delivery analgesia: a randomized controlled trial. Int J Obstet Anesth. 2011;20(1):3–9.

    Article  CAS  Google Scholar 

  23. Lavand’homme P. Chronic pain after vaginal and cesarean delivery: a reality questioning our daily practice of obstetric anesthesia. Int J Obstet Anesth. 2010;19:1–2.

    Article  Google Scholar 

  24. Eslamian L, Jalili Z, Jamal A, Marsoosi V, Movafegh A. Transversus abdominis plane block reduces postoperative pain intensity and analgesic consumption in elective cesarean delivery under general anesthesia. J Anesth. 2012;26:334–8.

    Article  Google Scholar 

  25. Mishriky BM, George RB, Habib AS. Transversus abdominis plane block for analgesia after cesarean delivery: a systematic review and meta-analysis. Can J Anaesth. 2012;59:766–78.

    Article  Google Scholar 

  26. Abdallah FW, Halpern SH, Margarido CB. Transversus abdominis plane block for postoperative analgesia after caesarean delivery performed under spinal anaesthesia? A systematic review and metaanalysis. Br J Anaesth. 2012;109(5):679–87.

    Article  CAS  Google Scholar 

  27. Blanco R, Ansari T, Girgis E. Quadratus lumborum block for postoperative pain after caesarean section: a randomised controlled trial. Eur J Anaesthesiol. 2015;32:812–8.

    Article  Google Scholar 

  28. Blanco R, Ansari T, Riad W, Shetty N. Quadratus lumborum block versus transversus abdominis plane block for postoperative pain after cesarean delivery: a randomized controlled trial. Reg Anesth Pain Med. 2016;41:757–62.

    Article  CAS  Google Scholar 

  29. Dam M, Moriggl B, Hansen CK, Hoermann R, Bendtsen TF, Børglum J. The pathway of injectate spread with the transmuscular quadratus lumborum block: a cadaver study. Anesth Analg. 2017;125(1):303–12.

    Article  Google Scholar 

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Authors and Affiliations

  1. Women’s Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar

    Amber Naz & Mitko Kocarev

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  1. Amber Naz
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  2. Mitko Kocarev
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Correspondence to Mitko Kocarev .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, Intensive Care and Perioperative Medicine, Women’s Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar

    Roshan Fernando

  2. Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA

    Pervez Sultan

  3. Department of Anaesthesia, Frimley Park Hospital, Frimley, UK

    Sioned Phillips

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Naz, A., Kocarev, M. (2022). Pain Relief After Caesarean Delivery. In: Fernando, R., Sultan, P., Phillips, S. (eds) Quick Hits in Obstetric Anesthesia. Springer, Cham. https://doi.org/10.1007/978-3-030-72487-0_11

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  • DOI: https://doi.org/10.1007/978-3-030-72487-0_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-72486-3

  • Online ISBN: 978-3-030-72487-0

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