Pregnancy and Childbirth
Conditions
Interventions
Bupivacaine infiltration on the subcutaneous layer group
GROUP B
Group C
Sponsors
abdullahi musa olatunji
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: All consenting pregnant women for elective or emergency caesarean section with live fetuses under subarachnoid block (regardless of numbers of previous caesarean delivery).
Exclusion criteria
Exclusion criteria: Patients that: 1. Are not able to understand or use the pain scoring system (mentally retarded, behavioural disorders). 2. Have proven or suspected allergy to local anaesthetics, pentazocine or paracetamol 3. Are opioids dependent or addicted 4. Have morbid obesity (BMI > 40) 5. Have sickle cell disease, uncontrollable diabetic mellitus or other chronic medical conditions that can affect wound healing (cardiac, hepatic or renal insufficiency) 6. Eventually have recourse to General anaesthesia for any reason. 7. Eventually have complications during surgery such as postpartum haemorrhage, major injury to visceral structures, intrauterine foetal death, major congenital malformation or neonatal intensive care unit admission within first 24 hours of life.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time of first analgesic request in the groups. [Time of first analgesic request defined as time interval after completion of caesarean section (end of skin closure) to time patient first request for analgesic.] | — |
Secondary
| Measure | Time frame |
|---|---|
| (a) Maternal static and dynamic pain scores using NRS at 0 hour (30 minutes after surgery), 2 hours,4 hours,6 hours,8 hours, 12hours, and 24hours (b) The total amount of rescue analgesia consumed over the 24 hour duration. will be calculated by adding the total rescue analgesia administered to the patients over the 24 hour period. (c) Time from surgery to mobility – time frame from end of surgery to ambulation. Participants will be requested to make an attempt to move out of bed 7 hours post operatively when the effect of spinal block would have stopped, then 2 hourly thereafter. The time of first successful attempt shall be recorded. (d) Time from surgery to breastfeeding: participants will be asked during the 24hrs duration for the convenience of breast feeding unaided 4 hours after surgery, then 2hourly till she can breastfeed by herself. if she is able to do so, the time of first attempt at breast feeding is recorded. For those that may not be able to breastfeed due to events like neonatal intensive care unit (NICU) admission shall be excluded from the study. Most times, need for NICU admission will be known before skin closure. (e) Maternal-to-neonate attachment satisfaction: participants will be allowed to carry their babies as frequent as they desire after surgery. Their satisfaction about the attachment will be scored using 5 point likert scale as very satisfied, satisfied, undecided, dissatisfied and very dissatisfied (f) Surgical site wound hematoma: Postoperative surgical site hematoma at 24 hours wound check (g) Side effects: evaluation and documentation will be taken (h) Cost analysis between the groups (i). Patient satisfaction with analgesia: The patients will be asked about their satisfaction with analgesia and their assessment recorded. The 5 point likert scale will be used where satisfaction will be assessed as very satisfied, satisfied, undecided, dissatisfie | — |
Countries
Nigeria
Contacts
Public ContactIDOWU OGUNLAJA
SUPERVISOR
Outcome results
None listed