Post-caesarean analgesia

Post-caesarean section analgesia is centred on the concept of multimodal analgesia. The analgesic regimen should provide optimal pain relief with minimal maternal side effects and minimal infant exposure via breastfeeding. Neuraxial opioids (morphine, diamorphine, fentanyl, pethidine) are utilized since regional techniques are commonly administered during caesarean section. Systemic analgesia using opioid based patient controlled analgesia (morphine, fentanyl) is commonly used when general anaesthesia is administered during caesarean section. To reduce opioid adverse effects, paracetamol and non-steroidal anti-inflammatory agents are commonly prescribed concomitantly. Increasingly, local anaesthetic blocks are used such as the transversus abdominis plane block to improve analgesia especially when general anaesthesia is administered or neuraxial morphine is not used.