Analgesia on discharge following a caesarean section – a step in the right direction!

                                                           P. Verghese, B.Bhaktavatsalam, C. Kenyon

                                                                      Liverpool Womens Hospital

Introduction

Inadequate management of pain following a caesarean section (LSCS) is a cause for significant morbidity in the mother.1,2 An audit carried out in our institution in 2020 identified inadequate analgesia on discharge home with associated poor maternal satisfaction. A subsequent quality improvement (QI) project introduced a standardised multimodal analgesia prescription on discharge. The survey presented here assesses the impact of the QI project from the patient’s perspective.

Methods

A total of 50 patients who underwent LSCS (25 elective and 25 emergency) between January and February 2023 were contacted via telephone and asked a series of questions to determine the adequacy of post operative analgesia. Responses were collected and a comparison was made with the findings of the previous audit.

Results

In their feedback, most women reported to be very satisfied with the pain relief provided with many contrasting this with their previous pregnancy in which they didn’t receive any pain relief on discharge (Table 1). A few patients discontinued taking dihydrocodeine due to side effects such as drowsiness, nausea, and constipation.

Discussion

Our survey has demonstrated that introduction of an analgesia pack on discharge following CS along with with good patient education can positively impact patient care and outcomes. Education plays a vital role in preventing reattendance at hospital or contact with other healthcare providers for analgesia.We would advocate for all patients to be discharged with analgesia post CS as would be done with many, more minor, surgical procedures. Providing adequate analgesia on discharge is a small outlay with the potential for major patient physiological and psychological benefits.  

References