Caesarean Sections: How painful are they when the block is ‘working’? An audit of our current practice

 

There is a well-established incidence of pain during caesarean births (CB) [1] under regional anaesthesia (RA), sometimes requiring conversion to general anaesthesia (GA). This can cause psychological sequalae for the patient and is also the leading cause of litigation in anaesthesia [2] and as such presents a cost in terms of time and money to healthcare systems.

 

We present a retrospective audit of the current incidence and aetiology of pain during CB in 2495 patients at a tertiary UK obstetric hospital over an 18 month period.

 

 

The incidence of pain during CB under RA and conversion to GA was similar to previously documented in our centre [1]. Figures 1 and 2 display a wide variety of experiences of pain. There is limited research on intra-operative patient pain experiences and this is could be an area for future research.

 

Block checks were commonly carried out using Ethyl Chloride spray and not using light touch; at odds with recent guidance [2]. Concerningly, pre-operative consent for pain during CB was poor for ETU possibly because more ETUs take place in the emergency setting. Both of these points are clear areas for improvement and are the subject of current educational drives and we look forward to sharing our results at future meetings.