Evaluation of Bupivacaine Injection Instillation Directly in the Rectus Sheath in LSCS Cases as an Effective Analgesia Method

Background

An ideal post-cesarean section analgesic plan should aim for high-quality pain relief with minimal side effects, no risk of transfer through breast milk, and a faster return to normal maternal functioning. This study is aimed to assess the efficacy of analgesic action of direct infiltration of bupivacaine in patients undergoing LSCS.

Methods

This was a retrospective cross-sectional record analysis, assessing the medical records of 49 patients who were included from the medical records department of Apollo hospital, Belapur, Navi Mumbai.

Results

49% patients did not require analgesics in the first 12 h postoperatively. The mean time of first demand of analgesia was 3.44 h (SD = 5.45). 61.2% patients were mobilized in 14 h or less postoperatively. In 69.4% patients, oral intake was initiated within 3 h of the surgery. 73.5% patient’s initiated breastfeeding immediately after the surgery. At 4 h after surgery, the pain score was an average of 0.49 (SD = 0.79). 79.6% patients did not report postoperative nausea and vomiting. No patients reported wound infection or dehiscence post-surgery.

Conclusion

Bupivacaine infiltration post-cesarean section is a safe, effective and convenient method since it requires minimal available resources and no additional skills or supervision from medical experts. Hence, it is more suitable, especially in developing countries and rural/peripheral hospitals/maternity centers where the availability of equipment like USG machine may be difficult, making cheap, accessible yet effective analgesic options the need of the hour in post-LSCS patients.

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