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Rev Esp Anestesiol Reanim (Engl Ed) ; 67(3): 167-175, 2020 Mar.
Article de Anglais, Espagnol | MEDLINE | ID: mdl-32085919

RÉSUMÉ

The number of caesarean sections performed worldwide is increasing, and with it, the need for the optimal analgesia strategies. Deficient postoperative analgesia increases the need for opioids, delays recovery, and is associated with chronic pain and postpartum depression. It is essential to find good postoperative pain control strategies that facilitate early mobility, early recovery, and early hospital discharge with minimal side effects on the mother and infant. Multimodal analgesia based on neuroaxial anaesthesia with morphine in combination with non-opioids such as non-steroidal anti-inflammatory drugs and paracetamol, gives the best post-caesarean analgesia outcome, and allows anaesthesiologists to reserve opioids, corticoids, gabapentin, magnesium or ketamine for situations where neuroaxial anaesthesia cannot be performed, for high-risk patients, or when pain is difficult to control. Peripheral nerve block techniques can also be added, such as transverse abdominis plane block, erector spinae block, or continuous wound infiltration.


Sujet(s)
Analgésie obstétricale/méthodes , Analgésiques morphiniques/administration et posologie , Anti-inflammatoires non stéroïdiens/usage thérapeutique , Césarienne , Morphine/administration et posologie , Douleur postopératoire/thérapie , Acétaminophène/administration et posologie , Analgésiques non narcotiques/administration et posologie , Analgésiques morphiniques/effets indésirables , Anesthésie péridurale/méthodes , Anesthésie obstétricale/méthodes , Rachianesthésie/méthodes , Douleur chronique/thérapie , Clonidine/administration et posologie , Épinéphrine/administration et posologie , Femelle , Humains , Morphine/effets indésirables , Néostigmine/administration et posologie , Bloc nerveux/méthodes , Grossesse
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