[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.
Solt
Ido
I
Maternity Department, Western GaLilee Hospital Naharia, Israel Faculty of Medicine, Technion, Haifa, Israel. Ido.Solt@naharia.health.gov.il
Melcer
Ann
A
Yehieli
Itana
I
Ophir
Ella
E
Bornstein
Jaco
J
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