Introduction
Caesarean section (CS) is one of the most common surgical procedures worldwide. In 2016, the rate of caesarean delivery was 18.6 %, ranging from 6 % to 27.2 % in the least and most developed countries, respectively. (1)
When obstetrical complications occur, CS is a life-saving procedure with clear maternal and foetal benefits. However, if there is no indication, it is not related to any maternal or foetal advantages.
As with any surgery, CS is associated with short- and long-term risks; principal among them are infectious, haemorrhagic, and thromboembolic. Postoperative pain management allows early rehabilitation and poor pain control results in decreased satisfaction with care, prolonged recovery time and increased use of health care resources and cost. (2)
Traditionally after major surgical procedures, opioids are used as first line post-operative medication for moderate to severe pain. Despite their efficacy, they are associated with unpleasant side effects, including nausea, vomiting, pruritus, drowsiness, and a risk for respiratory depression. In order to counter this, alternative pain killer techniques have emerged. Continuous subfascial wound infusion using a multi-orifice catheter with a local anaesthetic has been suggested as an effective method. However, data about its efficacy are lacking, given the conflicting results presented in randomized controlled trials. (3–13)
Since adequate postoperative pain management remains the primary goal after surgery, continuous wound infusion with a local anaesthetic could possibly improve patient’s postoperative outcomes. The aim of this study was to evaluate the role in pain management of continuous ropivacaine subfascial wound infusion after caesarean delivery.