Post-operative pain after caesarean section

Inadequate pain relief after caesarean section is a topic of international concern. At Oslo University Hospital, Ullevål, patients receive bupivacaine infiltration local anaesthesia as well as oral paracetamol, ibuprofen and oxycodone for pain management during the first 24 hours post-surgery. The aim of this study was to survey pain after acute and elective caesarean sections in our department.

The study included 50 patients who had undergone acute or elective caesarean section. Pain intensity on an 11-point numerical scale, pain duration, degree of mobilisation, and use of analgesia on postoperative day one were obtained from patient interviews and medical records.

Inadequate pain relief was defined as an average pain intensity of ≥ 4 and was reported by 34 patients (68 %). Total opioid consumption on postoperative day one exceeded 40 mg oral oxycodone equivalents in 28 patients. Of these, seven patients received more than 60 mg oral oxycodone equivalents.

A large proportion of patients had high pain intensity and opioid requirement in the first 24 hours after caesarean section.