The effect of pre-incisional local xylocaine injection on post-operative pain after caesarean section / Sahar Mamdouh Saber Youness ; Supervised Basma Makin Abdelasem Elrefai , Hala Abdelwahab Abdellatif , Gomaa Zahry Hussien

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Delivery by caesarean section is becoming more frequent, so management of Post-caesarean section pain is an important issue in obstetrics . Childbirth is an emotion-filled event, and the mother needs to bond with her baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation. Local anaesthetics have been employed as an adjunct to other methods of postoperative pain relief. local lidocaine infiltration of wound of cesarean section could significantly reduce post-cesarean pain and also reduce consumption of narcotics /analgesics used for post-cesarean pain relief. Populations of the study were comprised of 100 pregnant full term female, going to have cesarean section. All patients had cesarean section under general anesthesia and received post-operative analgesia declofenac sodium 75ml supp., every 12 hours, additional analgesia in form of pethidine 50mg IM upon patient request. Pain was assessed using a 10 point visual analogue scale (VAS) after 1 2, 4, 6, 12 and 24 hours post- operatively. The amount of pethidine consumed after 1, 2, 4, 6, 12 and 24 hours was calculated. They have been randomized into 2 groups: 1-The 1st group A (n=50 women): The wound was infiltrated just before start of C.S with 10ml of 0.9% saline. Patient received declofenac sodium 75ml supp., during the immediate postoperative period and repeated every 12 hours for the first 24 hours, additional analgesia in form of pethidine 50mg IM upon patient request. 2-The 2nd group B (n=50 women): The wound was infiltrated just before start of C.S, with 10 ml of 2% lidocaine. Patient received declofenac sodium 75ml supp., during the immediate postoperative period and repeated every 12 hours for the first 24 hours, additional analgesia in form of pethidine 50mg IM upon patient request. There was statistically highly significant difference between group B using 10ml of 2% lidocaine compared to control group A in first 4hours in postcasearean section pain and pethidine consumption. We concluded that infiltration of wound of cesarean section with 10ml of 2% lidocaine just before start of caesarian section under general anaesthesia provided a significant degree of analgesia as shown by smaller pain scores and reduction in pethidine consumption

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