Use and costs of pain management in cesarian section

Abstract

Aim.  To study the use of drugs for pain management for cesarean section and their cost on time and the first day after surgery. Methods.  A retrospective analysis of 117 anesthesia cards and childbirth histories of women after a cesarean section was performed. We analyzed drug therapy aimed at reducing pain during 1 day after cesarean section and performed a comparative analysis of the cost of drugs used in spinal and epidural anesthesia. Results.  Regional methods of anesthesia, epidural and spinal, were used in 95% of all cases. Spinal anesthesia was performed in 77 women, epidural — in 34 women. The frequency of prescribing opioid analgesics was higher with spinal anesthesia compared with epidural: trimeperidine (intramuscular) was used in 62 (83%) of 77 patients for spinal anesthesia and 1 (3%) of 34 for epidural anesthesia (p <0.05). There were no differences in the use of ketoprofen in the postoperative period with epidural and spinal anesthesia. The total cost of medicines used to control pain during and on the 1st day after surgery, with epidural anesthesia, was almost 10 times higher than that of spinal anesthesia: 938 and 98 rubles, respectively. Conclusion.  To control pain during cesarean section, in addition to local anesthetics, trimeperidine was used more often with spinal than epidural anesthesia; in the postoperative period, ketoprofen and trimeperidine were used with the equal frequency with greater use of ropivacaine with epidural anesthesia through a stored catheter; this has caused a higher cost of pain management during and in the first day after cesarean section with epidural anesthesia.