Cesarean Section
Conditions
Keywords
local anesthetics infiltration, cesarean section pain relief
Brief summary
Thus study evaluates the advantage of infiltration of the surgical wound by local anesthetics in cesarean section on post operative pain relief. In the study group before closing the skin, both sides of the incision (top and bottom) will be infiltrated by 30 ml of 0.25% BUPIVACAINE and ADRENALIN at 1: 200,000 concentration and then closing the skin. In the control group, the skin will be closed without infiltration. Our hypothesis is that subcutaneous infiltration of the surgical wound by BUPIVACAINE + ADRENALIN at the end of cesarean section will reduce the intensity of post operative pain.
Detailed description
Cesarean section is one of the most common procedures in the world. There is an advantage in preventing pain after cesarean section, as opposed to treating pain that has already started. The infiltration of surgical wounds by local anesthetics is accepted as an effective method for preventing pain after various operations. In this study women who are admitted for a cesarean section will be randomly allocated into 2 groups. In the study group after the closure of the fascia above the rectus muscles, and before closing the skin, both sides of the incision (top and bottom) will be infiltrated by 30 ml of 0.25% BUPIVACAINE and ADRENALIN at 1: 200,000 concentration and then closing the skin. In the control group, the skin will be closed without infiltration.
Interventions
DRUGIntervention
After closing the fascia above the rectus muscles, and before closing the skin, the subcutaneous layer will be infiltrated on both sides of the incision (top and bottom) by 30 ml of 0.25% BUPIVACAINE and ADRENALIN at 1: 200,000 concentration and then closing the skin.
Sponsors
HaEmek Medical Center, Israel
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* cesarean section with regional anesthesia * singleton * pfannenstiel incision
Exclusion criteria
* cesarean section with general anesthesia * maternal liver or kidney disease * allergy to Bupivacaine * allergy to Adrenalin * intrauterine fetal death * major fetal malformations
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Self reported pain intensity upon receipt of a woman after cesarean section to the maternity department. | up to 24 hours | Visual analogue scale pain severity with scale from 0 to 10, with score 10 representing the maximum level of pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of the cesarean section | up to 24 hours | Time from first incision to the end of incision closure |
| Time from surgery to mobility | up to 48 hours | Time from the end of surgery to mobility |
| Time from surgery to breastfeeding | up to 4 days | Time from the end of surgery to breastfeeding |
| Need for opioids | up to 4 days | Type and dosage of opioids needed |
| Surgical site hematoma | 4 days | Post operative surgical site hematoma |
| surgical site infection | up to 42 days | Post operative surgical site infection |
| questionnaire | up to 4 days | Post operative women's satisfaction with scale from 0 to 10, with score 10 representing the maximum level of satisfaction. |
| Length of stay from surgery to discharge | up to 4 days | Length of stay from surgery to discharge |
Countries
Israel
Outcome results
None listed