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

评估布比卡因注射液直接滴注腹直肌鞘在剖宫产手术中作为一种有效镇痛方法的效果

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Abstract

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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