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.