Audit of post caesarean section fain management in tawam hospital, Al Ain, United Arab Emirates

ABSTRACT

To evaluate the consistency in management of postoperative caesarean section pain in Tawam Hospital according to evidence based practice and to introduce change in practice and to bring uniformity in practice for post cesarean section pain relief. A retrospective audit of hundred consecutive women undergoing cesarean section in Tawam hospital, Al Ain, UAE from l[st] January 2008 till 30[th] April 2008. A purpose-designed performa was used to collect the data including the Body mass index BMI, Type of cesarean section, Duration of cesarean section, types of anesthesia, First pain scoring [day 0] and type, dosage and route of pain relief used and finally post medication pain score of patient. Tawam Hospital is a 500 bedded hospital with a delivery rate of 4000 per year and cesarean section rate of 15%. Patients who had a BMI >30kg/m[2] were 42%. Emergency caesareans were done in 60% of the patients. Most of the caesareans were completed within 1.5 hrs. Regional anesthesia was given in 59% of the cases. Analgesia requirement was reduced after regional anesthesia. Only 30% of the patients had pain scoring within the 1[st] hour of cesarean section. Patients received variable pain relief medications without correlation to the pain score. Post analgesia pain score was done in 62% of the patients only. There is no uniform or evidence based practice for post operative analgesia in cesarean section in our Institution therefore a Clinical practice guideline is issued to achieve evidence based practice and to reaudit to review change in practice.