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At the Royal Brisbane Women's Hospital, the women usually have epidural in situ for up to 24 hours (PCEA). QID Panadol and TDS NSAID (if not contraindicated) commenced in OT. NSAID usually ceased after 48 hours. Once PCEA is ceased and removed, 4/24 or PRN Endone(5-10mg; maximum dose 40mg daily) or Tramadol (50-100mg) may be given for breakthrough pain.
A few women came back with no epidural after morphine top-up. Some coped really well for 24 hours. Some needed stronger analgesics within the first 24 hours.
Some women tend to cope really well with regular panadol and NSAID the first two days. Others need regular stronger ones for example up to 40mg Endone Daily.
Some women have problems with constipation from Endone which resolve with odd doses of Metamucil or Lactulose.
We have a pain management team (anaesthetic registrar or RN who has been specially upskilled ) that visits the women first 24 hours and on call 24 hours/day.
Hope this helps.
Ping Bullock
-------Original Message-------
Date: 03/03/05 07:35:30
Subject: Re: [ozmidwifery] Analgesia post LUSCS
How many women have problems with constipation from the Panadeine Forte?
Nicole.
----- Original Message -----
Sent: Thursday, March 03, 2005 6:44 AM
Subject: Re: [ozmidwifery] Analgesia post LUSCS
Also from a small hospital. After a spinal for the CS the woman is given a naprosin supp and panadol supp. Then she is written up for 4 hourly Pethidine, BD Brufen or Naprosin and 6 hrly Panadiend Forte, all PRN. I find that not many women utilise the Pethidine, or maybe only one or two doses. They seem to be comfortable with the Panadiene Forte weaning through Panadiene and supplemented with the NSAID.
Cheers
Judy
Cheryl LHK <[EMAIL PROTECTED]> wrote:
Not exactly natural birth I know, but can you give me some ideas of what
your doctors/obst's order for analgesia days1-2 post LUSCS? Small hospital,
and each doctor tends to have his own ideas, and sometimes we end up with
all kinds of concoctions!! It doesn't make me very happy when I come onto
night-duty, find women teary, in pain with nothing more than Panadol some
days!
But I'm the first to admit that since I haven't a a LUSCS (three NVB's) I
tend to keep up the pain relief because I think it must be very, VERY
painful having major abdo surgery then up and learning about a baby as well.
Is the LUSCS recovery period any more or less painful than other abdo
surgery?
Thanks in advance.
Cheryl
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