English

Abstract

BACKGROUND: Opioid based analgesic regimens have been the gold standard for post caesarean analgesia until recently. Regional techniques like local intra-wound infusion techniques are becoming popular now. Our aim is to evaluate the efficacy of 0.2% Ropivacaine continuous wound infusion versus continuous epidural versus conventional systemic analgesia for post caesarean delivery. METHODOLOGY: 60 healthy parturients of ASA I/II were randomized after elective caesarean section into 3 groups of 20 each. Group-A: Received 0.2% Ropivacaine via an epidural catheter placed into subcutaneous tissue and fascia before skin closure at the rate of 5ml/hr. through infusion pump. Group-B: Received 0.2% Ropivacaine continuous epidural infusion via an epidural catheter at the rate of 8ml/hr. An initial bolus of 10ml was given in groups A&B. Group-C: Received standard systemic analgesia with diclofenac sodium and rescue opioid. Post operatively parturients were assessed for VAS scores for pain at rest and during movement, total Ropivacaine consumption, Tramadol consumption and side effects. Data were analyzed using SPSS software version 22. RESULTS: There were no significant differences in the mean VAS scores at rest and at movement between groups A or B and C. The consumption of Tramadol was significantly greater in Group C (p value AC=0.025, BC=0.0000) than A or B. Mean Ropivacaine consumption is significantly higher in Group B (p=0.000) than Group A. CONCLUSION: Continuous local intra-wound analgesia with Ropivacaine produced comparable analgesia to that of continuous epidural and superior analgesia compared to standard systemic analgesia.