Oral analgesia in the treatment of post-cesarean pain.

Objective: Cesarean section is one of the most common operations. The new technologies of postoperative pain treatment such as patient-controlled analgesia, are expensive and may limit women caring for their newborns shortly after delivery. The present study assessed patient satisfaction with oral analgesia following cesarean section.

Study Design: An open prospective study was conducted on all women who had a cesarean section with epidural analgesia, during two consecutive periods of 3 months each. In the first group of 109 women, an oral solution of 1 g dipyrone was allowed every 4 h, upon patient request. Patients requesting additional analgesia were administered a tablet of 30 mg immediate-release morphine sulfate. In the second group of 90 women, the same protocol was used; however, oral morphine was the drug of choice and dipyrone was used for rescue analgesia. Pain intensity and satisfaction were self-evaluated by patients using a visual analog scale.

Results: The results of each study period were independently evaluated. The demographic and obstetrical variables were similar in both groups. The duration of analgesic effect of dipyrone was 6.5 h and the satisfaction score was 90. The duration of analgesic effect of oral morphine was 5.05 h and the satisfaction score was 83.7. Overall, patients in both groups requested only 25% of the permissible dosage of analgesia.

Conclusions: Oral analgesia following cesarean section provides satisfactory pain relief, is easily administered, and is a substantially less costly alternative to the new pain treatment technologies currently in use.