title: Postoperative analgesia following caesarean deliveries in a rural health district of South Africa.
abstract: The under-treatment of postoperative pain is prevalent worldwide. This cross-sectional study examined general practitioners' (GPs) knowledge and practices regarding postoperative analgesia in Caesarean deliveries. Postoperative analgesia was said to ensure that patients were pain-free (38.7%), achieved early mobilization (19.4%) and enabled early breast feeding (16%). Pethidine was the opioid of choice; normally prescribed eight hourly (69%) and was combined with non-steroidal anti-inflammatory drugs (NSAID) by 48.6% of doctors and used solely by 51.6%. The prescription of analgesics was mainly influenced by drug availability (45.2%) and potency (19.4%). Most doctors (93.5%) had never attended a pain management course or used pain scores. Doctors at level 1 hospitals were less likely to use pethidine in combination with NSAID (odds ratio: 0.11; confidence interval: 0.02-0.59) compared to those in the specialized hospital. The GPs recognized the importance of postoperative analgesia, but their practices made patients vulnerable to pain after caesarean section.
authors.affiliation: Department of Health, Mpumalanga, Province.
authors.forename: M F
authors.initials: MF
authors.lastname: Khan
authors.forename: O B
authors.initials: OB
authors.lastname: Omole
authors.forename: G J O
authors.initials: GJ
authors.lastname: Marincowitz
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002585:Cesarean Section; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008614:Meperidine / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy*; D010821:Physicians, Family; D012424:Rural Population; D013019:South Africa
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D008614:Meperidine