OBSERVATIONAL STUDY TO ASSESS THE EFFICACY OF POST-OPERATIVE PAIN MANAGEMENT IN CASES OF CAESAREAN SECTION

Context:The incidence of cesarean deliveries is on the rise now-a-days. Post-operative pain is a major problem and if untreated, can lead to chronic pain.

Aims: To observe the effectiveness of the obstetrician led post-operative analgesia regime in patients operated for caesarean section.

Settings and Design:The observational study was conducted at a rural based tertiary care centre, designed to include all the patients who fulfilled the selection criteria for caesarean section.

Methods and Material:After approval from institutional ethics committee and patients informed consent, the multimodal analgesic regime was evaluated on Visual analogue scale (VAS) at rest for 24 hours. A questionnaire was also taken as feedback from the patients at end of 24hrs for qualitative assessment.

Statistical analysis used: Descriptive analysis of the data collected was done.

Results: 91.5% patients had VAS score < four while 8.5% patients had VAS score > four.  The percentage of patients who were fully satisfied, partially satisfied, not at all satisfied and in severe pain was 18%, 68%, 13.5% and 0.5% respectively.  The newborn care was not at all affected in 17.5%, somewhat affected in 76.5% and to a great extent in 6% patients. In 89% patients, sleep was not affected while in 11% it was affected. Majority of patients (99%) did not mind bearing mild pain in order to prevent side effects of drugs.

Conclusions: Overall, the obstetrician led postoperative analgesic protocol followed was satisfactory. Discrepancy between patient satisfaction by VAS score assessment and patient perception by qualitative assessment suggests requirement of in-depth qualitative assessment for better pain control.