Management of Pain after Caesarean Section and the Maternal Implications

Abstract

Salam Hadid, Esther Perez, Farida Morani, Cathrine Bibar, Jacob Bornstein, Maya Wolf

Objective: Post-cesarean pain management affects both the mother and the newborn. Administration of intravenous acetaminophen is an accepted pain control treatment option. The aim of the study is to examine the effectiveness of IV Acetaminophen every 8 hours for the first 24 hours post-op in post-cesarean patients.

Design: A prospective quantitative research study

Setting: At the maternity ward

Participants:102 women after cesarean section Intervention: All women treated according to a pain protocol of intravenous Acetaminophen. Pain was recorded with the Visual Analog Scale (VAS), and then patients were questioned 48 post-op about the pain experienced and its influence on functioning ability.

Findings:The medication reduced pain level by 2-4 points on the VAS. Mean maximum pain reported in the first 24 hours was VAS=5.61, in the next 24 hours 4.54. However, mean maximum pain remembered by the patients was VAS=7.99 in the first 24 hours and 7.07 in the next 24 hours. Most women maintained that the medication helped to reduce their pain but that the pain hindered their ability to perform tasks such as moving and leaving the bed, caring for the newborn and breastfeeding.

Key Conclusions: There is disparity between level of pain reported by women in ‘real time’ and that recalled in self-report 48 hours post-op. Despite pain alleviation by medication, functioning was still problematic. In addition to pain evaluation, function analysis is also necessary

Implications for Practice: Pain evaluation is insufficient; evaluation and intervention of maternal function is also necessary.

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