Plan for better Caesarean pain relief

Wednesday July 8th, 2009

Mothers undergoing a Caesarean section could be given local anaesthetic to reduce the need for painkillers, researchers report today.

Local injections of anaesthetic can be given as well as general anaethetic.

Cochrane Researchers made the recommendation after reviewing data from 20 studies in developing and developed countries that involved 1,150 women.

They found that women treated with local anaesthetic, as well as local or regional anaesthesia, needed less morphine or other opioid drugs for pain relief after their operations. When non-steroidal anti-inflammatory drugs were also given, pain was reduced further.

But medical staff have to consider the cost of including local anaesthetics in the pain management strategies, especially as one-quarter of all births in the USA, Canada and the UK are delivered by Caesarean section.

Lead researcher, Anthony Bamigboye, of the Department of Obstetrics and Gynaecology at the University of Witwatersrand in Johannesburg, South Africa, said improved pain relief allowed mothers to bond with their babies and begin breastfeeding more quickly.

But he said a cost-benefit analysis needed to be drawn up to see if it were advantageous.

"None of the trials in this review addressed the cost implications of increasing use of local anaesthetic," he said.

"A cost benefit analysis is needed to find out whether increased expenditure on theatre time and local anaesthetic can be offset by reductions in postoperative painkillers."

The researchers found that administering local anaesthetics - injected to block nerves in the abdominal wall or applied directly to the wound as an anaesthetic solution - in addition to general or regional anaesthetics helped manage pain during and after operations.

Bamigboye AA, Hofmeyr GJ. Local anaesthetic wound infiltration and abdominal nerves block during caesarean section for postoperative pain relief. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD006954. DOI: 10.1002/14651858.CD006954.pub2.

Tags: Africa | Childbirth and Pregnancy | Women’s Health & Gynaecology

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