Post-cesarean section analgesia

Verstraete, Stefan; Velde, Marc Van de

doi:10.1016/j.bpa.2022.02.006

Cited by 15 publications

(8 citation statements)

References 45 publications

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“…patched analgesia) the addition of epidural morphine or an opioid should be the first consideration. If the catheter does not work, the analgesic strategy may be the use of IV opioids or ultrasound-guided regional techniques [14].…”

Section: Neuraxial Analgesiamentioning

confidence: 99%

Perioperative Analgesia in Caesarean Section: What’s New?

Saucillo-Osuna¹,

Wilson-Manríquez²,

López-Hernández³

et al. 2023

Topics in Postoperative Pain

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Caesarean section is associated with moderate to severe postoperative pain during the first 24 hours after surgery. Inadequate pain management can influence recovery, maternal psychological well-being and breastfeeding. In the search of alternatives to minimize the use of systemic opioids, new recommendations have been made to implement protocols to improve recovery after caesarean section, with multimodal analgesia, new suggestions for neuraxial techniques, regional analgesia with ultrasound-guided fascial plane blocks and non-pharmacological approaches. Some of the interventions, such as epidural or spinal blocks, although effective, carry a significant risk of complications (for example post-puncture headache). In their place, newer alternatives such as interventions guided by ultrasound are safe and effective for relieving pain in this common clinical context. The goal of this chapter is to provide clinicians with up-to-date evidence for optimal pain management after elective caesarean section.

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Section: Neuraxial Analgesiamentioning

confidence: 99%

Perioperative Analgesia in Caesarean Section: What’s New?

Saucillo-Osuna¹,

Wilson-Manríquez²,

López-Hernández³

et al. 2023

Topics in Postoperative Pain

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“…So far, many studies has been performed for appropriate management of postoperative pain after CS. The multiplicity of studies and modalities indicates the lack of a clear and reliable method in reducing postoperative pain and shows that acute postoperative pain management after CS still remains a problem ( 10 – 11 ). At present, opioids, especially their injectable form, are widely used as the first line and gold standard modality in relieving acute postoperative pain after surgery, including CS ( 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of Intranasal Ketamine on Pain Intensity after Cesarean Section: A Single-Center, Double Blind, Randomized Controlled Trial

Firouzian

Faghani-Makrani

Nazari

et al. 2023

Ethiop J Health Sci

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BACKGROUND: Although intravenous or intramuscular opioids are widely used for managing postoperative pain after cesarean section (CS), their side effects are bothering and limit their use. The aim of this study was to determine the effect of intranasal ketamine on pain intensity after CS. METHODS: In a single-center, double-blind, parallel-group, randomized controlled trial, a total of 120 patients who were scheduled for elective CS were randomly assigned into two groups. After birth, 1 mg of midazolam was administered to all patients. In addition, 1 mg/kg intranasal ketamine was administered to patients in the intervention group. For patients in control group, normal saline was administered intranasally as a placebo. The severity of pain and nausea in the two groups was evaluated after 15, 30 and 60 minutes, as well as 2, 6 and 12 hours after the initial administration of the medications. RESULTS: The trend of changes in pain intensity was decreasing and these changes were statistically significant (time effect; P<0.001). The pain intensity in the placebo group was higher than the intervention and the observed difference was statistically significant, regardless of the time studied (group effect; P<0.001). In addition, it was shown that regardless of the study group, the trend of changes in nausea severity was decreasing and these changes were statistically significant (time effect; P<0.001). Regardless of the time studied, the severity of nausea in the placebo group was higher than the intervention group (group effect; P<0.001). CONCLUSION: According to the results of this study, it seems that the using of intranasal ketamine (1 mg/kg), can be considered as an effective, well tolerated and safe method in reducing pain intensity as well as the need for postoperative opioid consumption after CS.

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“…L a cesárea es la cirugía más frecuente en el mundo. En general, el dolor posoperatorio en esta cirugía es comúnmente reportado con intensidad moderada a severa, pudiendo así retrasar el retorno a la actividad habitual e incluso persistir y cronificarse [1]. Se ha descrito que el dolor severo puede estar presente en al menos una de cada 10 pacientes [2].…”

Section: Introductionunclassified

Bloqueos de nervios periféricos en cirugía cesárea anestesia y analgesia, en dolor agudo y crónico

Aliste¹,

Rivera²,

Erpel³

2023

Rev. chil. anest.

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Cesarean section is the most frequent surgery in the world and postoperative pain is commonly reported as moderate to severe. Thus, timely multimodal analgesia, based on systemic agents and neuraxial hydrophilic opioids, is the current recommended standard. The role of peripheral nerve blocks has accumulated some evidence on this subject. The most published blocks are the transverse abdominis muscle plane blocks, the quadratus lumborum muscle plane blocks, and the most recently described, the erector spinae muscle plane block. More classic blocks, such as thoracic paravertebral or ilioinguinal-iliohypogastric nerve blocks, have limited evidence in comparison. To date, peripheral blocks neither replace nor add to the analgesic role of neuraxial opioids in cesarean surgery. However, there is room to investigate these blocks in specific scenarios. For instance, studies looking for the benefits of more lasting blocks, their role as rescue alternatives for cases still in pain after a standardized treatment, and their pertinence in patients with a high risk of severe pain becoming a chronic entity are granted. Regardless of the technique, but especially in fascial plane injections, the vulnerability to local anesthetics' systemic toxicity should be considered. Therefore, operators must follow the current guidelines for preventing and treating this complication.

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Post-cesarean section analgesia

Cited by 15 publications

References 45 publications

Perioperative Analgesia in Caesarean Section: What’s New?

Perioperative Analgesia in Caesarean Section: What’s New?

Effect of Intranasal Ketamine on Pain Intensity after Cesarean Section: A Single-Center, Double Blind, Randomized Controlled Trial

Bloqueos de nervios periféricos en cirugía cesárea anestesia y analgesia, en dolor agudo y crónico

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