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Local Anesthetic Reduces Need For Painkillers Post-Op

July 7, 2009

Giving a local anesthetic during a Caesarean section helps manage pain after the operation and can reduce consumption of painkillers, according to Cochrane Researchers. The researchers recommend local anesthetics as part of integrated pain management strategies for Caesarean section operations, provided that consideration is given to the cost.

“This review is particularly important in light of the growing number of women giving birth by Caesarean section,” says lead researcher, Anthony Bamigboye, of the Department of Obstetrics and Gynaecology at the University of Witwatersrand in Johannesburg, South Africa. “Improved pain relief allows mothers to bond with their babies and begin breastfeeding more quickly.”

Caesarean sections account for around a quarter of all births in the US, Canada and the UK. Local anesthetics can be given, in addition to general or regional anesthetics, to help manage pain during and after operations. The anesthetic is either injected to block nerves in the abdominal wall or applied directly to the wound as an anesthetic solution.

The researchers reviewed data from 20 studies that together involved 1,150 women who gave birth by Caesarean section in both developing and developed countries. They found that women treated with local anesthetic as well as local or regional anesthesia did not require as much morphine or other opioid drugs for pain relief after their operations. When non-steroidal anti-inflammatory drugs were also given, pain was reduced further.

One concern, however, is the additional cost of giving local anaesthetic. “None of the trials in this review addressed the cost implications of increasing use of local anesthetic,” says Bamigboye. “A cost benefit analysis is needed to find out whether increased expenditure on theatre time and local anesthetic can be offset by reductions in postoperative painkillers.”

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