Self Administered Oral Analgesia Compared with Parenteral Analgesia for Pain Relief after Cesarean Section in Mulago Hospital - Trial PACTR201704001522270

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Summary

Post-operative pain in mothers post cesarean section is significant since mothers as opposed to other surgical patients are expected to ambulate/recover earlier so as to take care of the babies. Pain not controlled inhibits early recovery and response.Post caesarean section pain is mainly managed using parental analgesia whose administration depends on the nursing staff. The ratio of nurses: patients is too small to enable the nurses provide adequate pain managements. Patients come out of theatre at different times, which makes it difficult for the nurses to administer analgesia on time, hence poor pain control after the operation.Poorly managed post caesarean section pain has been associated with longer hospital stay, complications and development of chronic pain. Given the other analgesic modalities, it is possible to alleviate the problem at hand which is mainly due to unavailability of the drugs as well as lack of enough staff nurses to administer the drugs.The aims of this study are; to evaluate whether pain management using oral analgesia (oral codeine and paracetamol) given to the patients to self-administer is better than the conventional prescribed injectable analgesics (opioids and NSAIDS) administered by the staff nurses,determine pain scores of post cesarean section mothers as monitored by the visual analogue score, VAS in both arms,determine the level of patient compliance to self-administered oral analgesia (codeine and paracetamol) post cesarean section using questionnaires and determine need for break through parenteral analgesia in codeine/paracetamol group as well as parenteral pethidine and diclofenac group.

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