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Postoperative pain management following caesarean section in University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria.

OBJECTIVE
To assess the common methods of analgesia used in our hospital following caesarean section, their effectiveness and patient satisfaction.


DESIGN
A prospective descriptive study.


SETTINGS
The study was conducted at the University of Ilorin Teaching Hospital (UITII), Ilorin, Nigeria over a period of 18 months (February 1999 - July 2000).


METHODOLOGY
We studied prospectively the methods used for postoperative analgesia in 88 consecutive patients who had elective caesarean section under general anaesthesia. Pain assessment was carried out by direct questioning method using a 4-point verbal rating scale of none, mild, moderate and severe, in the recovery room, and on the mornings of days 1 and 2 postoperatively. Patients' satisfaction of pain relief was assessed on day 2 on a 2-point scale of satisfactory or unsatisfactory. The postoperative drug sheets and medication charts were also reviewed and analysed.


RESULTS
Surgeon-prescribed, nurse-administered intermittent intramuscular administration of analgesics was the method used for postoperative pain control in all the patients. Pentazocine was prescribed in 86.4% of patient while the remaining 13.6% had Tramadol. Most of the patients (95%) experienced some degree of pain in the immediate postoperative period. The first 24 hours postoperatively was particularly painful for the patients with 79.6% and 54.6% reporting moderate to severe pain in the recovery room and on day 1 respectively. However, despite the high incidence of pain most of the patients (85.2%) still expressed satisfaction with the level of pain relief.


CONCLUSION
Pain remains a significant problem following surgical operations in our environment.