The Current Consideration, Approach, and Management in Postcesarean Delivery Pain Control: A Narrative Review

Sangkum, Lisa; Thamjamrassri, Thanyalak; Arnuntasupakul, Vanlapa; Chalacheewa, Theerawat

doi:10.1155/2021/2156918

Cited by 10 publications

(12 citation statements)

References 161 publications

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“…Managing pain during and after childbirth is a primary concern. 42 However, postoperative pain’s implications go beyond immediate discomfort. Caesarean sections often result in significant postoperative pain, affecting post-recovery, patient satisfaction, breastfeeding, and mother-child bonding.…”

Section: Discussionmentioning

confidence: 99%

“…Persistent pain can hinder maternal-fetal bonding and early breastfeeding. 42 , 43 Our study focused solely on pain measurements and could not assess broader impacts. Postoperative pain can lead to short and long-term consequences, including postpartum depression, persistent pain, and various psychological, familial, social, and economic challenges.…”

Section: Discussionmentioning

confidence: 99%

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Transversus Abdominis Plane Block versus Epidural Anesthesia for Pain Management Post-Caesarean Delivery: A Pilot Study

Salazar-Flórez,

Arenas-Cardona,

Marhx

et al. 2024

LRA

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Background Effective post-operative analgesia profoundly influences patient recovery and outcomes after caesarean delivery. The Transversus Abdominis Plane (TAP) block represents a potential alternative, potentially offering greater effectiveness than epidural analgesia while causing fewer adverse effects. Objective To assess if the abdominal transverse block provides superior postoperative pain relief in patients undergoing caesarean delivery compared to epidural analgesia. Methods Participants were divided into parallel groups: an experimental group receiving TAP block (n=25) and a control group receiving epidural analgesia (n=24). All patients received a 10 mg dose of hyoscine at the end of the surgery. Experimental Group received a total of 20 mL of 0.2% ropivacaine. In Epidural group received 0.2% ropivacaine at 4 mL/h for 24 hours. All participants were administered combined with neuroaxial block anesthesia. The patients selected for epidural analgesia received the mentioned dose, while the other group block had the epidural catheter removed after the cesarean section. The primary outcome was post-caesarean pain, evaluated using the Visual Analog Scale (VAS) at four intervals (0, 6, 12, and 24 hours). Also, surgical bleeding and residual motor were evaluated. VAS pain scores between the groups were compared using the Friedman test and Generalized Linear Model (GLM) for non-normally distributed data. The effect size was estimated with Eta Square ( ), considering values ≥0.38 as indicative of large effects. A two-tailed p-value < 0.05 was deemed statistically significant. Results Statistically significant differences in pain scores were noted at 0 and 6 hours post-surgery (p<0.01). The TAP block group reported lower pain scores at 0 hours (mean=0.04) and 6 hours (mean=1.16) compared to the epidural group, reflecting a substantial effect size. Conclusion The TAP block proves advantageous in mitigating postoperative pain for women post-caesarean delivery, particularly in the initial 6 postpartum hours. This relief promotes early mother-infant bonding and facilitates breastfeeding.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Transversus Abdominis Plane Block versus Epidural Anesthesia for Pain Management Post-Caesarean Delivery: A Pilot Study

Salazar-Flórez,

Arenas-Cardona,

Marhx

et al. 2024

LRA

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“…NSAIDs are analgesic, antipyretic and anti-inflammatory drugs that inhibit the COX pathway of prostaglandin production [6]. Specifically, prostaglandin E2 and…”

Section: Nonsteroidal Anti-inflammatory Drugsmentioning

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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“…Cesarean delivery is associated with severe postoperative pain 1 . The most important benefits of optimizing postoperative pain control are early mobilization, ease of newborn care, early discharge from the hospital, and better patient satisfaction 2,3 . Combining systemic and regional techniques, a multimodal approach is recommended for postoperative pain management in patients undergoing cesarean surgery 4,5 .…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of erector spina plane, quadratus lumborum blocks, and intrathecal morphine for analgesia after cesarean: a randomized study

Aksoy,

Yilmaz

et al. 2023

Rev. Assoc. Med. Bras.

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and Reanimation, from June 2022 to May 2023. The aim of this study was to compare the effectiveness of ultrasound-guided erector spinae plane block, quadratus lumborum block, and intrathecal morphine to decrease postoperative pain after cesarean section. METHODS: Sixty-term pregnant women who were scheduled for elective cesarean sections with spinal anesthesia were included. Patients were randomly divided into three groups (n=20 for each group): Group 1: Patients were administered intrathecal morphine during spinal anesthesia; Group 2: Patients performed bilateral erector spinae plane block postoperatively; and Group 3: Patients performed bilateral quadratus lumborum block postoperatively. In the postpartum care unit, patients received intravenous Patient-Controlled Analgesia. The Patient-Controlled Analgesia devices were set to administer an intravenous bolus of 25 μg fentanyl, with a lockout interval of 10 min. Opioid consumption and maximum pain score in the 24 postoperative hours were recorded. RESULTS: Patients in Group 1 had a longer time to first analgesic requirement compared to Group 2 (p=0.017). Opioid consumption and resting and moving visual analog score scores in the first 24 h postoperatively were similar between groups. CONCLUSION: All three methods, including intrathecal morphine, erector spinae plane block, and quadratus lumborum block, are efficacious and comparable in providing postoperative analgesia after cesarean under spinal anesthesia.

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The Current Consideration, Approach, and Management in Postcesarean Delivery Pain Control: A Narrative Review

Cited by 10 publications

References 161 publications

Transversus Abdominis Plane Block versus Epidural Anesthesia for Pain Management Post-Caesarean Delivery: A Pilot Study

Transversus Abdominis Plane Block versus Epidural Anesthesia for Pain Management Post-Caesarean Delivery: A Pilot Study

Perioperative Analgesia in Caesarean Section: What’s New?

The effectiveness of erector spina plane, quadratus lumborum blocks, and intrathecal morphine for analgesia after cesarean: a randomized study

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