Quality of Post-Cesarean Section Pain Management at Referral Hospital in Kigali Rwanda: A Cross-Sectional Study

Studies in high-income settings have demonstrated that pain management after Cesarean section leads to higher patients' satisfaction. However, little is known about the quality of pain management and patients' satisfaction among parturients undergoing cesarean in low resources settings.

A cross-sectional study was conducted for 385 parturients from May 2020 to October 2020 at a referral hospital in Kigali Rwanda. The sample size was calculated: S = Z² × P × (1-P)/M². S = (1.96)2 × 0.5 × (1-0.5)/(0.05)2 = 384.16≈385. Parturients aged over 18 years who underwent cesarean were enrolled prior to surgery and followed up within the first 24 hours post cesarean. Data on patients' characteristics, type of analgesia, type of anesthesia, pain scores, and patients' satisfaction were collected and analyzed.

Age group 26-33 years 199(51.7%) underwent cesarean section and 201(52, 2%) were elective cesarean section; 361 (93.8%) received spinal anesthesia. Most patients had pain control with low pain scores throughout the first 24 hours 90.1% except immediately after recovery admission 46.8% and 76.1% were satisfied. Morphine was associated with higher patients' satisfaction.

The quality of post cesarean section pain management within 24 hours at hospital is good leading to satisfaction among most patients. However, the quality of pain management was lower after leaving the theatre compared to other post-operative periods; this requires intrathecal morphine which was not used.