Zewdu Dereje, Tantu Temesgen, Olana Meseret, Teshome Diriba
Department of Anesthesia, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
Department of Gynecology and Obstetrics, College of Medicine Health Sciences, Wolkite University, Wolkite, Ethiopia.
Ann Med Surg (Lond). 2021 Mar 29;64:102255. doi: 10.1016/j.amsu.2021.102255. eCollection 2021 Apr.
Cesarean delivery (CD) is a commonly performed obstetric surgical procedure and causes moderate to severe postoperative pain. Wound site infiltration (WSI) is becoming a technique to provide postoperative analgesia in a limited-resource setting in regardless of controversy on its effectiveness. The current study is to assess its effectiveness as a part of postoperative analgesia for parturients undergoing elective Cesarean section.
A Hospital-based prospective cohort study was employed on 58 parturients that underwent elective Cesarean section. Study participants were allocated into the Wound site infiltration and Control group based on planned postoperative pain management. A student t-test was used for normally distributed data while non-normally distributed data were analyzed by Mann Whitney test. Pearson Chi-squared or Fisher's exact test were used to analyzing categorical data as appropriate. A p-value 0.05 considered as statistically significant.
The median time to request the first analgesia was significantly prolonged within Wound site infiltration 314.31 ± 47.71 in minutes compared to control group 216.9 ± 43.18 with a P-value of <0.001. The postoperative verbal NRS score was significantly reduced in Wound site infiltration compared to the control group at 4th and 6th hours with p values of <0.001 and 0.04 respectively.
Wound site infiltration performed following elective cesarean section under spinal anesthesia significantly prolonged time to request the first analgesia, decreases verbal NRS score, and total analgesic consumption within 24 h in postoperative period compared to control group.
剖宫产是一种常见的产科手术，会导致中度至重度术后疼痛。伤口部位浸润（WSI）正成为一种在资源有限的环境中提供术后镇痛的技术，尽管其有效性存在争议。本研究旨在评估其作为择期剖宫产产妇术后镇痛一部分的有效性。
对58例行择期剖宫产的产妇进行了一项基于医院的前瞻性队列研究。根据计划的术后疼痛管理，将研究参与者分为伤口部位浸润组和对照组。正态分布数据采用学生t检验，非正态分布数据采用曼-惠特尼检验分析。分类数据根据情况采用Pearson卡方检验或Fisher精确检验进行分析。p值<0.05被认为具有统计学意义。
与对照组（216.9±43.18分钟）相比，伤口部位浸润组首次请求镇痛的中位时间显著延长，为314.31±47.71分钟，P值<0.001。与对照组相比，伤口部位浸润组在术后第4小时和第6小时的术后言语数字评分量表（NRS）得分显著降低，p值分别为<0.001和0.04。
与对照组相比，在脊麻下择期剖宫产后进行伤口部位浸润可显著延长首次请求镇痛的时间，降低言语NRS得分，并减少术后24小时内的总镇痛药物消耗量。
