title: A randomized trial of postoperative wound irrigation with local anesthetic for pain after cesarean delivery.
abstract: OBJECTIVE
  The purpose of this study was to investigate the efficacy of continuous local anesthetic infusion system for pain control after cesarean delivery.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  The continuous local anesthetic infusion system appears to be effective in reducing postoperative morphine use after cesarean delivery.
authors.affiliation: Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, USA.
authors.forename: Vanessa A
authors.initials: VA
authors.lastname: Givens
authors.forename: Gary H
authors.initials: GH
authors.lastname: Lipscomb
authors.forename: Norman L
authors.initials: NL
authors.lastname: Meyer
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use*; D002585:Cesarean Section; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D010149:Postoperative Pain / Q000628:therapy*; D011182:Postoperative Care; D011247:Pregnancy; D011446:Prospective Studies; D007507:Therapeutic Irrigation
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine