Spinal versus general anesthesia in cesarean sections: the effects on postoperative pain perception.

OBJECTIVE: To compare postoperative pain perception and analgesia requirements in patients undergoing cesarean section (CS) using general versus spinal anesthesia. STUDY DESIGN: A prospective, observational study of patients undergoing elective CS during 2009 under either general or spinal anesthesia. Postoperative pain intensity and analgesia requirements were evaluated for up to 48 h after surgery. RESULTS: A total of 153 women were enrolled; 77 received general and 76 received regional anesthesia. Postoperative meperidine requirements in the first 24 h were significantly higher in the general anesthesia group. Pain scores were mostly comparable between the groups. Nevertheless, lower pain scores were graded after 8 h in the general versus the spinal anesthesia and this reversed at 48 h. CONCLUSION: Spinal anesthesia is comparable to general anesthesia in terms of post-operative pain control. In choosing the type of anesthesia in CS, other factors such as the urgency and potential maternal and fetal hazards should be taken into account.

Preoperative analgesia with local lidocaine infiltration for post cesarean delivery pain management.

OBJECTIVE: To evaluate the impact of local lidocaine incision-site injection in patients undergoing cesarean deliveries (CD), on post operative pain and analgesic requirements. STUDY DESIGN: In this prospective, double-blinded, placebo-controlled study, patients undergoing elective CD were randomly assigned to receive 1% lidocaine solution or placebo to the incision site, prior to the performance of a Pfannenstiel incision. Pain intensity was evaluated for up to 48 hours after surgery and analgesic requirements of the patients were recorded. RESULTS: During the study period, 153 patients were enrolled; 77 received pre-emptive analgesia with lidocaine and 76 received a placebo. No significant differences were noted between the groups in respect to parity, previous CD, maternal age and gestational age. Pain scores or requirements of analgesia did not differ between the groups. CONCLUSION: Pre-emptive analgesia with local incision-site injection with lidocaine does not seem beneficial in reducing post cesarean pain scores and analgesic requirements.