Pain management after cesarean section surgery- medicaments and methods: literature review

Eglė Žukauskaitė1, Lina Raišytė1 1Faculty of Medicine of the Medical Academy of the Lithuanian University of Health Sciences Abstract Background. Adequate postoperative analgesia after caesarean section surgery is very essential. It determines maternal healing process, recovery and the emotional state on which mother‘s and newborn‘s health depend. Opioid analgesics still remain the main choice for reducing postoperative pain but due to their side effects and possible addiction syndrome it is recommended to assess the situation individually and, if necessary, to use several drugs with different mechanisms – multimodal analgesia. The aim of this article is to analyse the possibilities and methods of postoperative analgesia after caesarean section, medications, their effects on the mother and the newborn. Materials and methods: a search of scientific articles was performed in PubMed, ScienceDirect, Cochrane, UpToDate databases. The search was performed using the selected keywords. The literature review includes 40 scientific publications describing the post-CPO analgesia, medications used, their side effects and complications. Results. It is currently recommended that multimodal analgesia be considered as the first-line treatment, starting with acetaminophen with NSAIDs during surgery and adding a weaker opioid after surgery. However, it is important to weigh the benefits and risks of breastfeeding when giving opioid analgesics to the newborn and to assess the side effects on the mother. Conclusions: 1. For women after CPO, the method of analgesia is selected individually according to the state of health and the woman’s wishes. 2. Multimodal analgesia is recommended for post-CPO pain relief in women. 3. It is advisable to use acetaminophen and NSAIDs during breast-feeding, if necessary, opioid analgesics may be given. 4. Side effects of analgesics depend on the dose administered. Keywords: caesarean section surgery, analgesia, multimodal analgesia.