الفهرس | Only 14 pages are availabe for public view |
Abstract Delivery by caesarean section (CS) is becoming more frequent and is one of the most common major operative procedure performed worldwide. In the USA a CS rate of 26% for all births is reported. The rate approaches 25% in Canada and is over 20% in England, Wales and Northern Ireland (CDC, 2006 and RCOG, 2001). Childbirth is an emotional experience for a woman and her family. The mother needs to bond with the new baby as early as possible and initiate early breastfeeding, which helps to contract the uterus and accelerates the process of uterine involution in the postpartum period (Novy, 1991). So Achieving optimal pain relief after cesarean delivery is an important issue due to a higher risk for thromboembolic events, because of the surgery and the hypercoagulable state of pregnancy and puerperium. In addition, these patients are highly motivated and desire early ambulation in order to breastfeed and care for their newborn (Roy Kessous et al., 2011). The degree of postoperative pain, as ultimately perceived by the patient, is multifactorial and depends on variables such as type and duration of the operation, type of anesthesia and operation, type of anesthesia and analgesia used, and the patient‘s mental and emotional status (for example: laparotomy for cesarean delivery versus laparotomy for uterine cancer (Pan et al., 2006). There are many methods of postoperative pain treatment. The traditional and most widely used is parenteral opioids. Parenteral narcotics in general are associated with nausea, vomiting, constipation, respiratory depression, and sedation. Newer technologies, such as continuous epidural analgesia or patientcontrolled analgesia, have adverse effects, are expensive, and require trained personnel and special equipment another option for postcesarean pain management is to administer oral analgesics immediately after the procedure (Faboyaa and Unclesb, 2007; Cohen and Smetzer, 2005 and Jakobi et al., 2000). Preemptive analgesia is an analgesic regimen initiated before the onset of tissue trauma and could have effects that outlast the pharmacokinetic presence of the intervention and its efficacy. It is based on the theory of prevention of central pain sensitization. Different techniques of preemptive analgesia have been reported, including intramuscular, intravenous,epidural , and local anesthetics used in peripheral nerve block, intraperitoneal instillation, or wound Infiltration (Moiniche et al., 2002 and Kaufman et al., 2005) This study was conducted on women in Ain Shams University Maternity Hospital.There was 480 patient allocated either to receive preoperative subcutaneous lidocaine (n=240) or saline (n=240). Our results show that no difference concerning demographic data and no observed maternal or fetal adverse effects. Significant differences were noted between the groups with regard to postoperative pain score in the first postoperative 2 hours(43.4+20 )for lidocaine group and (70+29)for control group and p value= 0.004 No statistical difference in post operative pain score after 2 hours. No significant difference between 2 groups concerning analgesic requirement. |