ĐÁNH GIÁ HIỆU QUẢ GIẢM ĐAU ĐA MÔ THỨC TRÊN SẢN PHỤ MỔ LẤY THAI TẠI BỆNH VIỆN SẢN-NHI TỈNH QUẢNG NGÃI

Abstract

Background: Pain relief after Cesarean section relates to the satisfaction of pregnant women, especially multimodal analgesia with spinal morphine combined with intravenous paracetamol and rectal diclfenac. Quang Ngai Hospital for Women and Children has also used this method for a long time, but up to now, there hasn’t been a study to evaluate the effectiveness after Cesarean section. Therefore, this study aims to evaluate the effectiveness of pain relief towards maternal pain. Objectives: To describe some clinical and paraclinical characteristics and evaluate the effectiveness of multimodal analgesia on women after Cesarean section. Methods: Prospective study, comparative clinical intervention performed on pregnant women with Cesarean section receiving spinal anesthesia at Quang Ngai Hospital for Women and Children from April 2020 to September 2021. Results: Clinical and paraclinical characteristics: Indications for laparotomy because of accounts for the highest percentage; group M 46.6%, group F 45%. Next is the genital tract cause (non-progressive labor, large fetus, pelvic disproportion) accounting for 30% in group M and 18.3% in group F. The mean gestational age in 2 groups M and F is 38.7 and 39 week, respectively. The vital signs before and during surgery are similar between the two groups. Changes in the total blood count and biochemical analysis between the 2 groups are within normal limits. Effectiveness of pain relief: Group M had good pain relief efficiency of 96.7%; quite reached 3.3%. Group F had a good pain-relieving effect, accounting for a lower rate of 86.7%. In the first 2 hours after surgery, the average VAS pain score at rest and on movement was less than 1 point. The average VAS pain score at rest and exercise from the 2^nd to the 24^th hour between the 2 groups was statistically significant. Pain score in group M is always smaller than in group F. The time to maintain pain score at 0 VAS in group M is statistically significant longer than in group F. In group M, VAS pain score of 0 lasted 118.33 ± 39.10 minutes. Most women are satisfied with the quality of pain relief at a good and very good level. Conclusions: Multimodal analgesia combined with spinal morphine, intravenous paracetamol and rectal diclofenac provides good analgesic effect with prolonged duration of complete analgesia and mean VAS pain score during 24 hours is always less than 2.