Bupivacaine-soaked absorbable gelatin sponges in caesarean section wounds: effect on postoperative pain, analgesic requirement and haemodynamic profile

•The use of bupivacaine-soaked sponges in caesarean section wounds was investigated.•This technique reduced postoperative pain scores and analgesic requirement.•Postoperative blood pressure and heart rate were lower in the study group.•The incidence of nausea and vomiting were lower in the study group.•The use of gelatin sponges can be a novel technique for post-caesarean analgesia.

BackgroundPain is a common distressing adverse effect in the early postoperative period following caesarean section. The aim of this study was to investigate the effect on postoperative pain, analgesic requirement and haemodynamic profile of placing a suprafacial bupivacaine-soaked absorbable gelatin sponge in the caesarean section wound.MethodsA total of 164 healthy patients scheduled to undergo general anaesthesia for elective caesarean section were randomised to a study group (n=81) or a control group (n=83). In the study group, a bupivacaine-soaked absorbable gelatin sponge was placed subcutaneously in the caesarean section wound. Intramuscular diclofenac 75 mg was given to all patients at 8-h intervals during the first 24 h. Postoperatively, visual analogue scale pain scores, requirement for pethidine and diclofenac and changes in blood pressure and heart rate were compared between groups.ResultsPain scores were lower in the study group compared to the control group at all assessments (P <0.001). During the first eight hours after surgery, fewer patients in the study group required rescue pethidine compared with the control group (4 vs. 33, P <0.001). In the study group, total opioid and diclofenac consumption was lower (P <0.001), and blood pressure and heart rate were lower (P <0.001) compared to the control group.ConclusionSuprafascial wound placement of a bupivacaine-soaked absorbable gelatin sponge improved postoperative analgesia and decreased opioid consumption following caesarean section.