Re: [ozmidwifery] Analgesia post LUSCS

[mh]

Where I work (large teaching hospital, dedicated 24hr "Pain Management 
Team," painrelief protocols codified by anaesthetic dept and adhered to by 
all from VMO down,) if LSCS was performed under epidural the women 
frequently have a bolus of Morphine down the EDB catheter prior to it being 
removed at the end of surgery. They are then managed with excellent pain 
relief with panadol and anti- inflammatories. There is a general ban on 
narcotics for 24 hrs but if necessary more analgesia would be arranged by 
the on site anaesthetic registrar after examination. Others who had a GA 
(and maybe a spinal) have a IV PCA using either Morphine or Fentanyl with 
the dosage and lockout time set by the anaesthetist at time of op but 
altered by on call anaesthetist if necessary (rare). This stays for maybe 2 
days. They also have regular panadol and usually Voltaren.
All, unless asthmatic etc, have PR Voltaren before leaving the op theatre.
Some also have reguar Endone but I can't remember which circumstances- I'm 
usually in Delivery.
The level of pain control seems fantastic, especially when contrasted with 
the 3/24 Pethidine I was given after an emergency LSCS 15 years ago. Then, I 
could barely move and it was only by grim determination that I was able to 
look after my daughter. (and bloodymindedness- no one else was having my 
baby!) Now they are up and around, moving slowly but quite easily and able 
to get in and out of bed with none of the agony I recall.
Hope that helps,
Monica
----- Original Message ----- 
From: "Cheryl LHK" <[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Wednesday, March 02, 2005 9:23 AM
Subject: [ozmidwifery] Analgesia post LUSCS


Not exactly natural birth I know, but can you give me some ideas of what 
your doctors/obst's order for analgesia days1-2 post LUSCS?  Small 
hospital, and each doctor tends to have his own ideas, and sometimes we 
end up with all kinds of concoctions!!  It doesn't make me very happy when 
I come onto night-duty, find women teary, in pain with nothing more than 
Panadol some days!

But I'm the first to admit that since I haven't a a LUSCS (three NVB's) I 
tend to keep up the pain relief because I think it must be very, VERY 
painful having major abdo surgery then up and learning about a baby as 
well. Is the LUSCS recovery period any more or less painful than other 
abdo surgery?

Thanks in advance.
Cheryl
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