Intraperitoneal instillation versus wound infiltration for postoperative pain relief after cesarean delivery | ||
| The Egyptian Journal of Fertility and Sterility | ||
| Volume 29, Issue 5 - Serial Number 11106352, September 2025, Pages 61-74 PDF (372.13 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/egyfs.2025.457889 | ||
| Authors | ||
| Hamed Elsayed Ellakwa1; Haitham Abu Ali Hamza2; Ahmed Tharwat Abudakika2; Asmaa Attia Shamsia* 3 | ||
| 1Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt | ||
| 2Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt | ||
| 3Obstetrics and gynecology deparM.B.B.Ch., FWE of medicine - Alexandria University, Resident of Obstetrics and Gynecology, Abu Elmatamir hospital, Beheira, Egypttment,abuelmatamer,Behira | ||
| Abstract | ||
| Techniques and individuals: this is a prospective, random-ized, double-blind, placebo-controlled trial was carried out at the Department of Obstetrics and Gynecology of both Menoufia University Hospital and, Abu Elmatamir General Hospital. 306 women were scheduled to undergo optional C/S through a Pfannenstiel incision under spi-nal anasthesia, were 34 weeks or older, divided into three groups, 102 of each 1- First, we injected 20 ml of nor-mal saline into the uterine peritoneum just prior to fascia closure. Next, 20 ml of a local anesthetic solution (10 ml of 0.5% bupivacaine and 10 ml of 2% lidocaine mixture) were injected subcutaneously before skin closure. 2- Sec-ond group (IPLA): we injected (10 ml 0.5% bupivacaine and 10 ml 2% lidocaine) into the uterine peritoneum, and 20 ml of normal saline was injected subcutaneously. 3- Placebo group: we injected 20 ml of saline into both the peritoneum of the uterus and subcutaneously. Results: The pain scores at rest at 2, 12, and 24 hours do not significantly differ across the three groups, (p >0.05) (p=0.184, 0.359 and 1.633, respectively). The pain scores after movement differ significantly only at two hours in the group of intraperitoneal instillation Compared to sub-cutaneous infiltration and placebo group, the IPLA group's pain score is significantly reduced (p<0.05),(P=0.003, 0.112 and 0.156, respectively). Conclusion: Administering lidocaine and bupivacaine in-traperitoneally appears to be a useful technique for reduc-ing post-caesarean pain, since it lowers the movement-re-lated discomfort score in women undergoing caesarean section under spinal anesthetic early. | ||
| Keywords | ||
| Intraperitoneal local anesthetic instillation; local anesthetic wound infiltration; postcesarean analge-sia | ||
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