الفهرس 
Anatomy and Physiology of PainOnly 14 pages are availabe for public view
 |  | from | 153 |  |  |
| | | from | 153 | | |
Abstract
Background: Caesarean section is one of the main surgeries performed in obstetric/gynecologic departments which its rate is increasing nowadays. Postoperative pain management after Caesarean section is an important component of adequate postoperative patients. There are many methods of postoperative pain treatment. The traditional and most widely used is parenteral opioids which have many adverse effects on the mother and her breastfed baby. Because of their analgesic properties andlack of opioid-induced adverse effects, local anestheticdrugs, administered via wound instillation, have become auseful alternative to opioid-based analgesic regimens for thetreatment of acute postoperative pain.
Aim of the work: The aim of the study was to evaluate the impact of local levobupivacaine and meloxicam incision site infiltration in women undergoing cesarean sections, on postoperative pain and analgesic requirements.
Patient and methods: One hundred and fifty six parturient had participated in this study, recruited from Ain Shams Maternity Hospital and divided into three study groups, each group contains 52 women, group L (Levobupivacaine group) in which the wound was infiltrated with 20ml of levobupivacaine hydrochloride, group M (Meloxicam group) in which the wound was infiltrated with meloxicam 15 mg/3ml diluted in 20 ml of 0.9% normal saline and group P (Placebo group) in which the wound was infiltrated with 20ml of 0.9% normal saline. Results:Post operative pain assessment was done using a 10 point isual analogue scale (VAS), after 1,4,6,12 and 24 hours postoperatively. All women received Diclofenac sodium 75mg IM on demand according to visual analogue scale. Postoperative pain scores, postoperative analgesic requirements and time to first rescue analgesia were assessed and statistically compared between the three groups.
Results: The study results showed that the VAS was significantly lower in the levobupivacaine group compared to the other two groups. The time to first rescue analgesia was significantly longer in the Levobupivacaine group compared to the other two groups and the number of rescue doses was significantly lower in the Levobupivacaine group. Also, the levobupivacaine group showed significantly the highest patient satisfaction rate among the three study groups with 90.4% (47 patients out of 52). No statistically significant post operative complications occurred with any of the three drugs.
Conclusion: Levobupivacaine is a well tolerated and effective local anesthetic that can be used to reduce pain scores and postoperative analgesic use if infiltrated in the surgical wound site in women after cesarean section deliveries.