Review Note
Last Update: 03/07/2025 03:53 AM
Current Deck: ACG Part 2::Obstetrics
New Card (Unpublished)Currently Published Content
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No published tags.
Pending Suggestions
Field Change Suggestions:
Front
Commit #296236
SS_OB 1.33 Evaluate methods for providing postoperative analgesia after caesarean birth
Back
Commit #296236Balanced multi-modal analgesia to reduce opioid consumption.
Allow maternal bonding and care
Safe breastfeeding with minimal transfer of analgesics to baby.
Multimodal pain regime for those receiving intrathecal morphine/ hydromorphone
- Regular Oral paracetamol
- Oral NSAIDs if kidney function allows
- PRN oxycodone/sevredol
Non-opiods
- Regular paracetamol
- Regularly scheduled oral or IV nonsteroidal anti-inflammatory drugs (eg ibuprofen, celecoxib)
Opioids
- PRN oxycodone/sevredol if received neuraxial morphine/hydromorphone
- If GA , consider PCA morphine, or start oral opioids with IV available for breakthrough pain
Regional
- TAP block :
- Meta-analysis of 14 trials found low dose <50mg bupivacaine gave similar analgesia to >50mg
- Quadtraus lumborum block (QLB)
- Associated with significant reduction in 48h opioid consumption
- Wound infiltration and wound catheters
- Evidence for other blocks (iliohyogastric, erector spinar, recutus shealth lacking in CS )
- Epidural is unlikely to stau in post delivery due to maternal requirement to care for baby
https://www.bjaed.org/article/S2058-5349(22)00020-8/fulltext