A randomized trial of postoperative wound irrigation with local anesthetic for pain after cesarean delivery

Objective: The purpose of this study was to investigate the efficacy of continuous local anesthetic infusion system for pain control after cesarean delivery. Study Design: This was a randomized prospective double-blind study. Patients who underwent cesarean delivery had a pain system implanted subcutaneously after closure of the fascia. Patients were randomized to receive an infusion of either 0.25% bupivacaine (n = 20) or normal saline solution (n = 16) into the wound for 48 hours. Postoperative pain (determined with a visual analog scale) and postoperative morphine use were assessed at 12, 24, and 48 hours. Results: There were no significant differences in patient demographics or visual analog pain scores at any time interval between the bupivacaine versus the placebo group. However, narcotic requirements to produce this amount of pain relief were significantly less in patients who received bupivacaine infusion rather than normal saline solution at all time intervals. Conclusion: The continuous local anesthetic infusion system appears to be effective in reducing postoperative morphine use after cesarean delivery. (Am J Obstet Gynecol 2002;186:1188-91.)