European Journal of Molecular & Clinical Medicine

Abstract

Aim: Evaluate The Intraoperative Anaesthesia Management and Postoperative Pain Scores
after Caesarean Section.
Methods: This analytical observational study conducted in the Department of
Anaesthesiology, Madha Medical College Kovur Chennai, India during Feb 2021 to Feb
2022. All patients either receiving GA or spinal anaesthesia for CS receive IV tramadol
infusion for post-operative pain control, which is started either at the request for first
analgesia in the PACU or at 60 min, whichever comes first. Patients are assessed for pain
using numerical rating scale (NRS) immediately in the PACU and at regular intervals. Any
patient having NRS >4 is given rescue analgesia.
Results: Percentage of patients having NRS >4 and who required rescue analgesia on
immediate assessment (time zero) was 15 (15%). After that, 13 patients (13%) at 30 min, 10
(10%) patients at 45 min and 5 (5%) patients at 60 min had NRS of >4 and required first
rescue analgesia. There was no statistically significant difference among patients in PACU
having NRS >4 from those having NRS <4 in terms of the type of incision, ASA grading and
duration of surgery. Patients receiving RA had a statistically significant (P-value < 0.01) low
percentage of patients with NRS >4 and need for first rescue analgesia at time zero and at 30
min when compared to the percentage of patients operated under GA. The difference became
insignificant after 30 min. Overall, 18% of patients received some sort of co-analgesia,
mainly in the form of IV paracetamol 15% and only two patients received TAP block.
Conclusion: The pain management in the PACU was adequate as all patients were given
rescue analgesia if they had NRS of >4 and no patient was shifted from PACU with NRS of
>4.