title: Women's postoperative experiences before and after the introduction of spinal opioids in anaesthesia for caesarean section.
abstract: OBJECTIVE
  The aim was to evaluate a new anaesthetic routine and to study the effect of spinal opioids for caesarean section on postoperative pain, expectations of pain, satisfaction with pain treatment, breastfeeding, infant care and length of hospital stay.
  
  
  BACKGROUND
  Inadequate postoperative pain relief is a problem among hospitalised patients. Women undergoing caesarean section have been shown to experience high levels of pain during the first days after operation. Women are expected to breastfeed and care for their newborn while recovering from major abdominal surgery and sufficient pain relief are of importance.
  
  
  METHODS
  Comparative patient survey.
  
  
  METHODS
  Data were collected through a questionnaire distributed to two independent samples of women undergoing elective and emergency caesarean section before and after the introduction of an additive of opioids in obstetric spinal anaesthesia. Chi-square tests were performed, and risk ratios were used for bivariate analysis. Logistic regression modelling was used for multivariate analysis.
  
  
  RESULTS
  The group of women undergoing caesarean section with opioids added to the spinal anaesthesia reported significantly lower levels of experienced pain. High pain levels irrespective of mode of caesarean section affected breastfeeding and infant care. Length of hospital stay for caesarean women was shortened and the consumption of analgesics was reduced.
  
  
  CONCLUSIONS
  Women receiving an additive of opioids in spinal anaesthesia experienced lower levels of pain. Low pain levels facilitate breastfeeding and infant care and are of relevance for financial considerations.
  
  
  CONCLUSIONS
  The results of this study indicate that spinal opioids for women undergoing caesarean section have a positive effect on the postoperative pain experience. Women undergoing caesarean section and have high pain levels are in special need of attention and care because of a higher risk of a decreased ability to breastfeed and to take care of their newborn.
authors.affiliation: Mid Sweden Research & Development Centre, Västernorrland County Council, Sundsvall, Sweden. annika.karlstrom@miun.se
authors.forename: Annika
authors.initials: A
authors.lastname: Karlström
authors.forename: Regina
authors.initials: R
authors.lastname: Engström-Olofsson
authors.forename: Astrid
authors.initials: A
authors.lastname: Nystedt
authors.forename: Mats
authors.initials: M
authors.lastname: Sjöling
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Hildingsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D011184:Postoperative Period
chemical_list: D000701:Analgesics, Opioid