• J Clin Nurs · May 2010

    Women's postoperative experiences before and after the introduction of spinal opioids in anaesthesia for caesarean section.

    • Annika Karlström, Regina Engström-Olofsson, Astrid Nystedt, Mats Sjöling, and Ingegerd Hildingsson.
    • Mid Sweden Research & Development Centre, Västernorrland County Council, Sundsvall, Sweden. annika.karlstrom@miun.se
    • J Clin Nurs. 2010 May 1;19(9-10):1326-34.

    AimThe aim was to evaluate a new anaesthetic routine and to study the effect of spinal opioids for caesarean section on postoperative pain, expectations of pain, satisfaction with pain treatment, breastfeeding, infant care and length of hospital stay.BackgroundInadequate postoperative pain relief is a problem among hospitalised patients. Women undergoing caesarean section have been shown to experience high levels of pain during the first days after operation. Women are expected to breastfeed and care for their newborn while recovering from major abdominal surgery and sufficient pain relief are of importance.DesignComparative patient survey.MethodsData were collected through a questionnaire distributed to two independent samples of women undergoing elective and emergency caesarean section before and after the introduction of an additive of opioids in obstetric spinal anaesthesia. Chi-square tests were performed, and risk ratios were used for bivariate analysis. Logistic regression modelling was used for multivariate analysis.ResultsThe group of women undergoing caesarean section with opioids added to the spinal anaesthesia reported significantly lower levels of experienced pain. High pain levels irrespective of mode of caesarean section affected breastfeeding and infant care. Length of hospital stay for caesarean women was shortened and the consumption of analgesics was reduced.ConclusionsWomen receiving an additive of opioids in spinal anaesthesia experienced lower levels of pain. Low pain levels facilitate breastfeeding and infant care and are of relevance for financial considerations.Relevance To Clinical PracticeThe results of this study indicate that spinal opioids for women undergoing caesarean section have a positive effect on the postoperative pain experience. Women undergoing caesarean section and have high pain levels are in special need of attention and care because of a higher risk of a decreased ability to breastfeed and to take care of their newborn.

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