Using Bupivacaine Injection Instillation Directly in the Rectus Sheath in LSCS Cases for Effective Analgesia

Post-cesarean section analgesic plan aims for effective pain relief with minimal side effects, no risk of transfer via breast milk, and a rapid return to normal maternal functioning. The present study assessed the efficacy of the analgesic action of direct infiltration of bupivacaine in patients undergoing LSCS by assessing their medical records. It found-

• No analgesic requirement in 49% of patients in the first 12 hours postoperatively. 
• The mean time of the first demand for analgesia was 3.44 hours. 
• 61.2% of patients were mobilized in 14 hours or less postoperatively. 
• 69.4% of patients started oral intake within 3 hours of the surgery. 
• 73.5% of patients initiated breastfeeding immediately following the surgery.
• The pain score was an average of 0.49, 4 h after surgery.
• 79.6% of patients did not experience postoperative nausea and vomiting. 
• No patients had wound infection or dehiscence post-surgery.

This study proves the safety and effectiveness of Bupivacaine infiltration post-cesarean section. Furthermore, it is a convenient method since it requires minimal resources and no additional skills or supervision from medical experts. Therefore, it is more suitable, particularly in developing countries and rural/peripheral settings where the availability of equipment like a USG machine may be difficult.

Dubey T, Yadav SD, Kundawar A. Evaluation of Bupivacaine Injection Instillation Directly in the Rectus Sheath in LSCS Cases as an Effective Analgesia Method. J Obstet Gynecol India. 2024. https://doi.org/10.1007/s13224-024-01947-z