Background: Post-operative pain control after Cesarean delivery is a major concern for both patients and physicians. The current literature provides mixed results on the effectiveness of the local continuous infiltration of anesthesia for pain control and reduction of morphine use. Methods: This was a randomized, double-blind, placebo controlled trial with a 1:1 group allocation. Fifty women who had a Cesarean delivery were randomly assigned to receive bupivacaine (Bupivacaine group) or saline (Saline group) delivered via locally placed catheters at the sub-fascial plane and at the uterine incision. Forty women (20 per group) completed the study. Total post-operative narcotic use and analog pain scale scores were used to evaluate effi cacy of treatment at 6, 12, 24 and 48 hours after surgery. Results: There was a reduction in pain and narcotic use in the Bupivacaine group at 6, 12, and 48 hours (p< 0.09). Regardless of group assignment, women who had a prior Cesarean section, versus primagravida women, had a higher total narcotic use (58.06 mg vs.38.28 mg, respectively;p< 0.03). Conclusions: Dual catheter placement and infusion of bupivacaine has potential to decrease the use of narcotics and decrease pain following cesarean section, however, given the small sample size in this study, a significant difference between groups could not be delineated. Further study is indicated to investigate catheter placement and its effects on pain control and narcotic use.
Yaklic, J. L.,
Dearmond, M. K.,
& Lindheim, S. R.
(2017). Effect of Continuous Local Anesthetic use for Pain Control and Narcotic use after Cesarean Section: A Randomized Trial. Open Journal of Surgery, 1 (1), 026-030.