Objective: To assess the common methods of analgesia used in our hospital following caesarean section, their effectiveness and patient satisfaction.
Design: A prospective descriptive study.
Settings: The study was conducted at the University of Ilorin Teaching Hospital (UITII), Ilorin, Nigeria over a period of 18 months (February 1999 - July 2000).
Methodology: We studied prospectively the methods used for postoperative analgesia in 88 consecutive patients who had elective caesarean section under general anaesthesia. Pain assessment was carried out by direct questioning method using a 4-point verbal rating scale of none, mild, moderate and severe, in the recovery room, and on the mornings of days 1 and 2 postoperatively. Patients' satisfaction of pain relief was assessed on day 2 on a 2-point scale of satisfactory or unsatisfactory. The postoperative drug sheets and medication charts were also reviewed and analysed.
Results: Surgeon-prescribed, nurse-administered intermittent intramuscular administration of analgesics was the method used for postoperative pain control in all the patients. Pentazocine was prescribed in 86.4% of patient while the remaining 13.6% had Tramadol. Most of the patients (95%) experienced some degree of pain in the immediate postoperative period. The first 24 hours postoperatively was particularly painful for the patients with 79.6% and 54.6% reporting moderate to severe pain in the recovery room and on day 1 respectively. However, despite the high incidence of pain most of the patients (85.2%) still expressed satisfaction with the level of pain relief.
Conclusion: Pain remains a significant problem following surgical operations in our environment.