الفهرس 
Anatomy of Anterior Abdominal WallOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
D
elivery by CS is becoming more frequent and is one of the most common major operative procedures performed worldwide. Prompt and adequate postoperative pain relief is therefore an important component of caesarean delivery.
Prolonged pain can reduce physical activity and leads to venous stasis and an increase risk of deep vein thrombosis and subsequent pulmonary embolism. In addition there can be wide spread effects on gut and urinary tract motility which may lead to post-operative ileus, nausea, vomiting and urinary retention. These problems are unpleasant for the patients and may result in prolonged hospital stay. Pain relief may cause good psychological and physical effects in patients, which could lead to better recovery from surgical procedures and early mobilization of patients to prevent complications like deep vein thrombosis etc.
Postoperative pain after CS is usually managed with opioids. Realistically, the analgesic efficacy of opioids is typically limited by the development of tolerance or opioid related side effects such as nausea, vomiting, sedation, or respiratory depression.
Local anesthetics cause reversible blockade of impulse propagation along the nerve fibers by preventing the influx of Na+ through the cell membrane of the fibers. Several studies have reported on use of pre-emptive local anesthetics to relieve postoperative pain, with results ranging from being beneficial to conferring no benefit.
Commonly used local anesthetic agents have side-effects, although these are very rare, ranging from allergy to CVS and CNS effects. Local anesthetics eventually get absorbed systemically and secreted in breastmilk, but their effects on breastfed babies have not yet been documented. This is in sharp contrast to morphine or pethidine, both of which have significant transfer to breastmilk and may have a sedative effect on the baby.
The objectives of our study was to assess the efficacy of local anaesthetic ”Bupivacaine” injection in both angles of the rectus sheath incision to reduce postoperative pain & consumption of opioids after caesarean section.
This study included 210 patients, 72 received Bupivacaine infiltration in in both angles of the rectus sheath incision,70 patients received saline infiltration in both angle of the rectus sheath incision and 68 patients received saline injection in the left angle and bupivacaine injection in the right angle.
The study compared the three groups &found significant difference regarding time for the first analgesic(meperidine) request, total amount of meperidine required, time interval before first ambulation, durtion of hospital stay , postoperative pain score & postoperative nausea &vomiting where group A showed the best outcome.
So the study had revealed that local anesthetic infiltration is effective in decreasing the intensity postoperative pain and the amount of the opioids consumption.