Comparison of opioid and non-opioid analgesia after caesarean section under general anaesthesia: a prospective observational study

Czech version

Authors: Štourač Petr ^1,3,6,8; Seidlová Dagmar ^1,5,8; Bártíková Ivana ¹; Kuchařová Eliška ⁴; Janků Petr ²; Křikava Ivo ^1,3; Huser Martin ²; Wágnerová Kristýna ²; Haklová Olga ³; Hakl Lubomír ³; Štoudek Roman ¹; Kosinová Martina ^1,3; Schwarz Daniel ⁶; Zelinková Hana ⁶; Ševčík Pavel ^3,7; Gál Roman ¹
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny, FN Brno a LF MU, Brno ¹; Gynekologicko-porodnická klinika, FN Brno a LF MU, Brno ²; Oddělení léčby bolesti, FN Brno, Brno ³; Lékařská fakulta, Masarykova univerzita, Brno ⁴; II. Anesteziologicko-resuscitační oddělení, FN Brno, Brno ⁵; Institut biostatistiky a analýz, Masarykova univerzita, Brno ⁶; Anesteziologicko-resuscitační klinika, FN Ostrava a LF OU, Ostrava ⁷; Expertní skupina pro porodnickou anestezii a analgezii při ČSARIM ⁸
Published in: Anest. intenziv. Med., 25, 2014, č. 1, s. 8-16
Category: Anaesthesiology - Original Paper

Overview

Objective:
The aim of the prospective observational study was to compare the efficacy of opioid vs. non-opioid analgesia in postcaesarean pain management.

Design:
Prospective observational study.

Setting:
University Hospital.

Materials and methods:
In the Non-opioid group (NO) we used a combination of regular paracetamol 1000 mg IV or PO and diclofenac 100 mg PR or IM. In the Opioid group (OP) we used piritramide 3 mg per hour IV continuously. Additional metamizole 2.5g IV was administered as rescue analgesic in both groups. We recorded the Visual Analogue Scale (VAS), Additional Analgesic Requests (AAR) and complications during the postcaesarean period. We compared the VAS and AAR scores in both groups in the first 24 hours after caesarean section (CS).

Results:
With the Ethics Committee Approval, we enrolled 160 patients (NO, N=120; OP, N=40) after CS under general anesthesia in the period of May 2009 – April 2010. The median VAS score in the first hour after CS was 3.5 in both groups (p=0.553). There were statistically significant differences in the VAS and AAR in the 1st and 24th hour after CS (p < 0.001). No serious complications were recorded.

Conclusion:
We found sufficient analgesic effect (VAS under 4) in both study groups with better effect of the opioid analgesics in the first postoperative day.

Keywords:
acute pain service – pain management – postoperative analgesia – caesarean section – opioids – non-opioids – obstetrics –general anaesthesia

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Article was published in

Anaesthesiology and Intensive Care Medicine

2014 Issue 1