[The treatment of post partum pain: survey of 26 maternity departments in Israel].
BACKGROUND
The majority of post-partum women suffer from pain after vaginal delivery, more so after cesarean section. In most cases, pain management is needed during the post-partum hospitalization period. In Israel there is no national protocol of post-partum pain management.


OBJECTIVE
Presentation of the current status of post-partum pain management used in Israeli hospital maternity departments as a basis for a national protocol of postpartum pain management.


METHODS
During the months of July and August 2008, Israeli maternity departments were surveyed by telephone interviews regarding their pain management protocols for post-vaginal deliveries and caesarean sections for both breastfeeding and non-breastfeeding mothers.


RESULTS
Treatment protocols were received from 26 maternity departments. All use paracetamol per-os alone or combined with another drug. Dipyrone is used in 22/26 departments, despite the fact that this medication is not approved for use during Lactation. In 15/26 departments, dictofenac is used mostly after caesarean sections. In nine departments, ibuprofen is used post-partum, and tramadol is used in seven. In 20/26 departments surveyed, opioids are used after cesarean section, mostly morphine or pethidine. Methadone is used after caesarean section in two departments.


CONCLUSIONS
Post-partum pain management treatment in Israelis not standardized, especially for Lactating mothers and women after caesarean sections. Lactating mothers should be started on paracetamol or ibuprofen per-os, as first-line postpartum pain management treatment. If this is not effective, second line treatment can be short-term morphine, codeine or propoxyphene. These medications are safer than acetylsalicylic acid, dipyrone or pethidine for lactating mothers.
Maternity Department, Western GaLilee Hospital Naharia, Israel Faculty of Medicine, Technion, Haifa, Israel. Ido.Solt@naharia.health.gov.il
Ido
I
Solt
Ann
A
Melcer
Itana
I
Yehieli
Ella
E
Ophir
Jaco
J
Bornstein
D000700:Analgesics / Q000627:therapeutic use; D002585:Cesarean Section / Q000009:adverse effects*; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007557:Israel; D009294:Narcotics / Q000627:therapeutic use; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data*; D010146:Pain / Q000188:drug therapy / Q000209:etiology*; D059408:Pain Management; D011247:Pregnancy; D011644:Puerperal Disorders / Q000188:drug therapy / Q000628:therapy*
D000700:Analgesics; D009294:Narcotics