Abstract
Based on the results of a prospective audit conducted in 2014 among 310 post caesarean section patients (Group A) at Tuen Mun Hospital, Hong Kong, a procedure specific postoperative pain management programme was implemented. To complete the audit cycle, a second prospective audit was conducted in 2015 among 332 patients (Group B). The proportion of patients with severe pain (VAS>=7/10) reduced significantly from 55.5% (Group A) to 23.0% (Group B) (p
Highlights
Post caesarean section (CS) patients usually suffer from moderate to severe pain postoperatively
The risks of analgesic techniques should balance against the benefits of pain therapy outcomes and this risk to benefit ratio depends on the type of procedure (e.g. Epidural analgesia offers complete analgesia after CS; its use is associated with motor impairment and urinary retention which affect breastfeeding and rehabilitation)
In Group B, the worst 24hr visual analogue scale (VAS) became 5 (IQR: 36) and patients with severe pain dropped to 23.0%
Summary
Post caesarean section (CS) patients usually suffer from moderate to severe pain postoperatively. Opioid use is associated with many side effects and long term problems, e.g. dependence, drug abuse. Multimodal analgesia is the combination of different classes of analgesics in optimal dosages that maximize efficacy and minimize side effects. Postoperative pain therapy should be procedure specific for several reasons. The efficacy of different analgesics differs between different procedures.[6] Thirdly, the risks of analgesic techniques should balance against the benefits of pain therapy outcomes and this risk to benefit ratio depends on the type of procedure (e.g. Epidural analgesia offers complete analgesia after CS; its use is associated with motor impairment and urinary retention which affect breastfeeding and rehabilitation). As part of the Quality Improvement Program, we introduced procedure specific pain management programme (PSPMP) in 2015 and evaluated its effectiveness by performing audits
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