The cesarean section is considered as a painful surgery during the post operative period. Mothers may need to move immediately after the surgery to take care of their babies. This may increase the risk of major pain and chronic pain. Thus, excellent postoperative analgesia is required so that mothers do not experience pain in caring for their baby. Currently, several techniques have been developed to manage postoperative pain related to c-section scar such as intrathecal morphine during spinal anesthesia or continuous pre-peritoneal wound infiltration. The comparison between anesthetic techniques has never been performed and it is still not know if the combination of intrathecal morphine plus continuous pre-peritoneal wound infiltration provide a synergistic or additional effect on pain relief.
The aim of this study is to compare the efficacy of continuous wound infiltration versus intrathecal morphine for postoperative analgesia after scheduled cesarean section. The primary endpoint is morphine consumption during the first 48 postoperative hours.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
150
Ropivicaine (0.2%) bolus of 10ml will be injected through the catheter after surgery and continuously infused during the postoperative period (8ml/H)
Morphine will be injected intrathecally (100µg) and oral morphine will be given during the postoperative period
Maternité Régionale Universitaire (MRU)
Nancy, Lorraine, France
RECRUITINGMorphine consumption during the first 48 postoperative hours
Time frame: at the 48th hour
Pain at rest and at mobilization
The pain at rest and at mobilization will be evaluated with both Visual Analog scale and Verbal pain scale. The patient should describe the worst pain felt during the previous 4 hours in a lying position and at mobilization
Time frame: Every 4 hours during the first 48 postoperative hours
Time to restoration of bowel function
Time frame: within the first 48 postoperative hours
Verbal and Visual analog pain scores in the first standing position
Time frame: at day 1
Number of patients that required oral morphine
Time frame: At the 24th and 48th hour
Number of patients that required local anesthetic rescue dose through the catheter
Time frame: At the 24th and 48th hour
Postoperative rehabilitation survey
Time frame: At the 48th hour
Occurrence of side effect
Itching, nausea and vomiting, drowsiness, urinary retention, hypoventilation, other will be assessed with a questionnaire
Time frame: During the first 48 hours
Postoperative residual pain (DN4 survey)
Time frame: At 3 months postoperatively
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