Literature DB >> 15167840

A hospital-sponsored quality improvement study of pain management after cesarean delivery.

Nicole P Yost1, Steven L Bloom, Miriam K Sibley, Julie Y Lo, Donald D McIntire, Kenneth J Leveno.   

Abstract

OBJECTIVE: We undertook this study to systematically assess prevailing pain management regimes used at our hospital in women after cesarean delivery. STUDY
DESIGN: Between August 1999 and July 2000, all women delivered by cesarean section at Parkland Hospital were assigned to 1 of 4 different pain management strategies: (1). intramuscular (IM) meperidine, (2). patient-controlled analgesia (PCA) meperidine, (3). IM morphine sulfate, and (4). PCA morphine sulfate. A combination of methods were used to compare these different pain management strategies. A survey questionnaire, using Likert scale responses, was administered to evaluate maternal satisfaction with pain control. Visual Analog Scale (VAS) scores and information regarding breastfeeding and rooming-in were also collected.
RESULTS: A total of 1256 women were allocated to the 4 analgesia study groups. The median meperidine dosages for the IM and PCA groups were 350 mg and 600 mg, respectively (P <or=.01). Conversely, the median IM morphine dose (65 mg) was significantly higher than that for the PCA group (60 mg). The percentage of women reporting moderate or worse pain (VAS scores 4 or more) was significantly lower in those women who received PCA meperidine compared with IM meperidine. Women who received morphine reported less severe pain compared with meperidine, regardless of route of administration. The patients' subjective report of satisfaction with pain management was not related to the method or drug used for pain control (P=.13). Fewer women assigned to morphine therapy stopped breastfeeding (P=.02) and more roomed-in with their infants (P <.01).
CONCLUSION: Pain relief was superior with the morphine regimens used and was positively associated with breastfeeding and infant rooming-in.

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Year:  2004        PMID: 15167840     DOI: 10.1016/j.ajog.2003.10.707

Source DB:  PubMed          Journal:  Am J Obstet Gynecol        ISSN: 0002-9378            Impact factor:   8.661


  6 in total

1.  Assessment and determinants of acute post-caesarean section pain in a tertiary facility in Ghana.

Authors:  Wisdom Klutse Azanu; Joseph Osarfo; Roderick Emil Larsen-Reindorf; Evans Kofi Agbeno; Edward Dassah; Anthony Ofori Amanfo; Anthony Kwame Dah; Gifty Ampofo
Journal:  PLoS One       Date:  2022-05-25       Impact factor: 3.752

2.  Race and satisfaction in general OB/GYN clinics.

Authors:  James E Rohrer; Jon D Lund; Susan Goldfarb
Journal:  BMC Womens Health       Date:  2005-05-12       Impact factor: 2.809

3.  Factors affecting public dissatisfaction with urban family physician plan: A general population based study in Fars Province.

Authors:  Mohammad Hadi Imanieh; Alireza Mirahmadizadeh; Bahareh Imani
Journal:  Electron Physician       Date:  2017-11-25

4.  Analgesic Effects of Preincision Ketamine on Postspinal Caesarean Delivery in Uganda's Tertiary Hospital: A Randomized Clinical Trial.

Authors:  Richard Mwase; Tonny Stone Luggya; John Mark Kasumba; Humphrey Wanzira; Andrew Kintu; Joesph V B Tindimwebwa; Daniel Obua
Journal:  Anesthesiol Res Pract       Date:  2017-02-21

5.  Analgesic effects of intravenous ketamine after spinal anaesthesia for non-elective caesarean delivery: a randomised controlled trial.

Authors:  Prahlad Adhikari; Asish Subedi; Birendra Prasad Sah; Krishna Pokharel
Journal:  BMJ Open       Date:  2021-06-30       Impact factor: 2.692

6.  Analgesic Effects of Intravenous Ketamine during Spinal Anesthesia in Pregnant Women Undergone Caesarean Section; A Randomized Clinical Trial.

Authors:  Shekoufeh Behdad; Mohammad Reza Hajiesmaeili; Hamid Reza Abbasi; Vida Ayatollahi; Zahra Khadiv; Alireza Sedaghat
Journal:  Anesth Pain Med       Date:  2013-09-01
  6 in total

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