Closure vs non-closure of peritoneum at caesarean section: evaluation of pain

We evaluated the effect of closure or non-closure of parietal and visceral peritoneum during caesarean section (CS) on post-caesarean pain and analgesic requirement. A total of 94 primigravidas planned for elective CS were prospectively enrolled into closure (n = 46) and non-closure (n = 48) groups. Analgesia was provided by a patient-controlled analgesia pump (PCA) postoperatively. Pain was evaluated using a visual analogue scale (VAS) and verbal rating scale (VRS). Total dose of analgesics administered through PCA and times of analgesia demand and additional analgesics were also assessed. VAS and VRS scores were similar between the groups. The total dose of analgesics administered were similar (p = 0.095) between groups, however the mean number of analgesic demand (p = 0.020) and the additional analgesics (p < 0.001) were higher in the closure group. As a conclusion, the closure or non-closure of the peritoneum does not have any impact on postoperative pain intensity, however the analgesia demand and additional analgesia requirement decreases with non-closure.