A Comparison of Two Regimens for Post-Caesarean Section Analgesia in a Tertiary Health Centre in Northern Nigeria

J. Ekweani, E. Ogboli-Nwasor, H. N. Madugu, S. Avidime

Abstract

BACKGROUND: Post-caesarean section pain is a problem in our
environment. Though many modalities for pain management exist,
there is the need to investigate safer and affordable regimens that will
provide adequate analgesia with minimal side effects and with ease of
administration. Alternating doses of intramuscular acetaminophen and
intramuscular pentazocine was studied as an alternative to provide safe
and effective post-caesarean section analgesia. Its effectiveness and
side effect profile in our environment have not been previously
investigated.
AIMS AND OBJECTIVES: The study aimed to compare the analgesic
and side effect profile of intramuscular pentazocine with another regimen
involving alternating doses of pentazocine and acetaminophen within
the first 48hours after surgery.
DESIGN OF THE STUDY:This was a prospective, comparative and
randomized study among 142 women who voluntarily consented to the
study and had elective caesarean section from May 2014 to May 2015
at the Ahmadu Bello University Teaching Hospital, Zaria.
Setting: The Study was conducted at the obstetrics and gynecology
department of the teaching hospital of Ahmadu Bello University, Zaria.
MATERIALS AND METHODS: Consecutive eligible pregnant women
who were slated for elective caesarean section were recruited at the
antenatal clinic unit of the department and randomized using the
WINPEPI software by Abramson to either receive intramuscular
pentazocine or alternating doses of pentazocine and acetaminophen
over the first 48hours after surgery. The pain scores, side effect profile
and the time taken for the return of bowel sounds were compared among
the two groups using relevant statistical methods with IBM SPSS version
20 with Z tests and chi-square to test for strength of relationships of
variables. The level of significance was 0.05.
RESULTS: The average age of the participants was 29.82years with
standard deviation 6.138; 64.8% were Hausa-Fulani, 71.83% were
Muslims, 45.07% were unemployed, 97.89% were married, 42.2% were
multiparous, 59.86% booked in our centre and 59.2% were having their
first caesarean section. Seventy-six participants received combination
of injection pentazocine/acetaminophen while 66 received pentazocine
injection alone. The drop-out rate was 8.5%. There was no statistically
significant difference in the pain scores both on the visual analogue
scale and the verbal rating scale in the first 48hours in both groups, no
difference in the need for rescue analgesics (p=0.709), time taken for
the return of bowel sounds (P=0.391), incidence of side effects (p=0.394)
and participants’ level of satisfaction (p=0.255).
CONCLUSION: Both regimens were comparable in analgesic efficacy,
incidence of side effects and satisfaction levels. WAJM 2022; 39(3):
217–222.
Keywords: Analgesia, Caesarean, Comparative, Pentazocine,
Acetaminophen, Intramuscular.