Abstract:
Abstract
Background: Cesarean section commonly induces moderate to severe pain for 48 hours postoperatively with 11.8% incidence of chronic pain. Adequate analgesia is mandatory to protect
the peri-operative complications of pain. For this purpose there are different options of post
cesarean section pain management modality. Para-incisional infiltration is an easy type of pain
management with different controversies of its efficacy.
Objective: This study was performed to investigate the efficacy of para-incisional infiltration
with bupivacaine after cesarean section under spinal anesthesia for the first 24 post-operative
hours at University of Gondar Specialized hospital, Ethiopia.
Methods: Institutional based prospective cohort study was conducted on ASAI and ASAII
parturient underwent cesarean section under spinal anesthesia from March to May 2018. A total
of 108 parturients (54 for each infiltrated and control groups) were included by convenience
sampling technique. Post-operative pain severity using NRS at rest and on movement/cough,
total analgesic consumption within 24hrs and time to first analgesia request was recorded and the
data was analyzed using SPSS version 20.
Result: Compared to the control group, para-incisional infiltration with bupivacaine after
cesarean section under spinal anesthesia reduced post-operative pain numerical rating scale
significantly at rest and on movement at the first 4thand 6th hours. It reduced total tramadol
consumption significantly within the first 24hrs (50 (50-100) mg versus 50 (0-50) mg; p <
0.001). Time to first analgesic request was significantly prolonged in the infiltrated group when
compared with the control group (480 (360-720) min versus 240 (240-270) min, p<0.001).
Conclusion and recommendation: Para-insisional infiltration with bupivacaine is an effective
and easy way of post cesarean section pain management modality for the first 6 post-operative
hours. Therefore we recommend that para-insisional skin infiltration after cesarean section as a
component of multimodal analgesia
