Case series: Efficacy of local infiltration analgesia with lidocaine 0.5% and adjuvant epinephrine as post cesarean section pain management in kalabahi public hospital

Abstract

Background: A caesarean section is one of the most commonly performed surgical operations in the world today. Caesarean section commonly induces moderate to severe pain for about 48 hours and therefore requires optimal perioperative pain management. Postoperative pain management is an important issue in the clinic. Proper and efficient pain management is necessary during hospitalization for preventing the related complications which could affect the mother and neonate health status. Recently, multimodal pain management has been tested for postoperative pain management. One of the alternatives that can be used is local infiltration analgesia (LIA) method. The LIA technique can provide an adequate effect of analgesia and reduced parenteral opioid consumption without any adverse effects. Case Presentations: Cases were taken from Kalabahi Public Hospital, East Nusa Tenggara, Indonesia. A total of 42 patients who met the inclusion criteria that underwent cesarean section were injected with lidocaine 0.5% with epinephrine in the abdominal muscle and subcutaneous layer as postoperative pain management. The patients were observed to evaluate pain score with the Visual Analogue Scale (VAS), opioid consumption as the pain rescue, the level of satisfaction, and to evaluate post-cesarean wound. Conclusion: Administration of lidocaine 0.5% with epinephrine reduced postoperative pain leading to early mobilization and increased patient satisfaction. There was no report of wound complication. The pain score of the first 24 hours was 2.095238 with standard deviation 0.878178, and just 4 of 42 patients asked for rescue analgesic.