The comparison of intraincisional bupivacaine infiltration and intravenous paracetamol administration for pain alleviation after cesarean section: a double-blinded randomized placebo controlled clinical trial.

OBJECTIVE

This study aimed to compare the analgesic effect of subcutaneous (SC) bupivacaine and intravenous (IV) paracetamol on postoperative pain and opioid requisites in patients undergoing cesarean delivery.

PATIENTS AND METHODS

One hundred and five women were allocated into 3 groups in this prospective, double-blind, placebo-controlled, randomized trial. Group 1 received SC bupivacaine, Group 2 received IV paracetamol following surgery and every 6 hours for 24 hours in the postoperative period, Group 3 received SC 0.9% saline and IV 0.9% saline at similar periods. Visual analogue scale (VAS) pain scores at rest and coughing, at 15 and 60 minutes, and 2, 6 and 12 hours, and total opioid necessity were measured.

RESULTS

VAS scores at rest were higher in placebo group than in bupivacaine and paracetamol groups at 15 minutes (p=0.047) and 2 hours (p=0.004). VAS scores at coughing were higher in placebo group than in bupivacaine and paracetamol groups at 2 hour (p=0.001) and 6 hours (p=0.018). Placebo group needed higher (p<0.001) doses of morphine than paracetamol or bupivacaine groups.

CONCLUSIONS

Intravenous paracetamol decreases pain scores similar to SC bupivacaine in the postoperative period compared to placebo. Patients taking bupivacaine or paracetamol need fewer opioids than placebo.