Cesarean delivery under local anesthesia: A literature review

Rezai, Shadi; Patel, Neil D.; Àlex,; Hughes, er C; Mercado, Ray; Takeshige, Takeko; Fuller, Paul N; Cass,; Henderson, ra E

doi:10.15406/ogij.2018.09.00326

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…The aim of this study is to establish the efficacy and safety of local infiltration of 7.5 mg/ml of ropivacaine as an analgesic in patients undergoing caesarean section by analyzing the total consumption of opioid and non-opioid systemic analgesics in first 24 hours following surgery. Ropivacaine acts by inhibiting the transmission of noxious stimuli from the site of injury by reversible hyperpolarization of peripheral nerve fibers and hence reduces the opioid consumption [8]. This study can open new dimensions in the management of pain in the postoperative period as all such advances are the need of the hour.…”

Section: Introductionmentioning

confidence: 99%

Local Wound Infiltration with Ropivacaine for Postoperative Pain Control in Caesarean Section

Nasir¹,

Sohail²,

Sadiq³

et al. 2019

Cureus

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BackgroundThe rate of the caesarean section has been on a progressive rise ever since its association with improved fetal prognosis was established. This study was conducted to assess the effect of local wound infiltration with ropivacaine on the postoperative analgesia requirement and pain scores in caesarean section patients.MethodsThis was a prospective single-blinded randomized control trial conducted at the Department of Obstetrics and Gynecology, KRL Hospital, Islamabad, Pakistan over a duration of six months from January 2018 to June 2018. All the women aged 19 to 40 years, who underwent elective caesarean sections under spinal anesthesia, with American Society of Anesthesiologists (ASA) score II, were included in the study and randomized into two groups. The primary outcome studied was the efficacy of ropivacaine in controlling postoperative wound pain compared to no local analgesic. Pain severity was assessed using the visual analog scale (VAS) which was explained to the patient beforehand and which comprised a range of score from zero (no pain) to 10 (worst pain imaginable). Initially, paracetamol 1 g intravenous (IV) was given every six hours, over 24 hours. If pain did not settle on this, ketoprofen 3 mg/kg IV was given every eight hours, and in case of further analgesic demand by the patient, nalbuphine 10 mg was given IV, if necessary. The data was collected on a specific questionnaire and analyzed on the Statistical Package for Social Sciences (SPSS Inc., Chicago, IL) version 23.0. A p-value of less than 0.05 was considered significant.ResultsA total of 100 patients were randomized into two groups. Pain scores were significantly reduced in the ropivacaine group at four, six, and 12 hours after surgery. The percentage of patients who requested the multiple doses of IV paracetamol, ketoprofen, and nalbuphine, was significantly lowered in the ropivacaine group as compared to the placebo group (p<0.001).ConclusionsLocal infiltration with ropivacaine during caesarean section significantly reduces the postoperative analgesic requirement and visual analog scores, reducing the incidence of side effects.

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Section: Introductionmentioning

confidence: 99%

Local Wound Infiltration with Ropivacaine for Postoperative Pain Control in Caesarean Section

Nasir¹,

Sohail²,

Sadiq³

et al. 2019

Cureus

View full text Add to dashboard Cite

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“…Long-acting local anesthetic ropivacaine is a complete left isomer with reduced cardiovascular and central nervous system toxicity possibility than bupivacaine. By preventing painful impulses from the location of the injury through the reversible hyperpolarization of distal nerve fibers, ropivacaine reduces the need for opioids [6].…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Post-Operative Pain Relief After Elective LSCS With Local and Intraperitoneal Ropivacaine Instillation Against Local Ropivacaine Infiltration Alone

Tripathi

THAKRE

NARREY

et al. 2023

Asian J Pharm Clin Res

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Objectives: For an anesthesiologist, the post-operative phase is just as crucial as the pre-operative and intraoperative periods. Whether a surgery is performed under regional or general anesthesia, the goal should always be to provide patients with a pain-free and comfortable recovery. Spinal anesthesia is frequently used during caesarean sections, but its effects only last for a few hours. As a result, various multidisciplinary analgesia strategies with few side effects have been attempted for postpartum patients to relieve pain because they may also be harmful to the newborn baby’s health. It has already been proven; injecting ropivacaine is a far safer alternative to injecting bupivacaine. We compared local infiltration of injectable ropivacaine alone to both intraperitoneal instillation and local infiltration for post-operative analgesia in individuals who had cesarean surgery. In the present study, intraperitoneal instillation and local infiltration of ropivacaine 0.5% were compared to local infiltration of ropivacaine 0.5% alone for the management of post-operative pain following elective cesarean section under spinal anesthesia. Methods: Pregnant women in ASA Grades I and II who were having a planned caesarean section under spinal anesthesia were divided into two groups at random (R1 and R2 group, each have 30 patients). Patients in Group R1 received a 15 mL injection of 0.5% ropivacaine at the incision site. Patients in Group R2 had intraperitoneal injections of 0.5% ropivacaine in 5 mL before to peritoneal closure and local infiltrations of 10 mL ropivacaine at the site of the incision before skin closure. The duration of the analgesia was calculated by timing the start of the sensory block to a point at which rescue analgesia was sought throughout the post-operative period. Pain intensity was measured using the visual analog scale (VAS). Data on the hemodynamics and side effects of the patients were also gathered. Results: Group R2 analgesia lasted much longer than that of Group R1 (p<0.05). The mean (±SD) analgesic duration in the R1 and R2 groups was 147.17±4.67 and 170.33±3.69 min, respectively. The mean (SD) VAS scores for Group R1 and Group R2 at the moment of the first analgesic demand were 36.7±5.14 and 32.6±6.52, respectively. Conclusion: When combined with intraperitoneal instillation during spinal anesthesia, inj. ropivacaine 0.5% local infiltration enhances post-operative analgesia in cesarean section procedures.

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Cesarean delivery under local anesthesia: A literature review

Cited by 2 publications

References 17 publications

Local Wound Infiltration with Ropivacaine for Postoperative Pain Control in Caesarean Section

Local Wound Infiltration with Ropivacaine for Postoperative Pain Control in Caesarean Section

A Comparison of Post-Operative Pain Relief After Elective LSCS With Local and Intraperitoneal Ropivacaine Instillation Against Local Ropivacaine Infiltration Alone

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