title: [Assessment of practices in postoperative analgesia in caesarean before and after implementation of an information program].
abstract: OBJECTIVE
  To assess the improvement of practices in postoperative analgesia after a cesarean section post implementation of a corrective program.
  
  
  METHODS
  Prospective impact study.
  
  
  METHODS
  After obtaining ethics approval, we included all patients undergoing a cesarean section at Montpellier University Hospital during February 2011 (PRE group) and March 2012 (POST group). The patients were interviewed on the fourth day postpartum about pain management and related data was collected from the chart. From March 2011 to February 2012, training sessions were held for the paramedical and medical teams.
  
  
  RESULTS
  Sixty patients were included in each group. The two groups were not significantly different. The mean overall numeric rating scale worst pain score between Day 0 and Day 4 in POST group was lower (5.5±2.5 vs. 6.5±2.4 p<0.01) and impairment during mobilization decreased significantly. Compliance with protocols improved in the POST group: the number of women receiving full analgesia regiment increased from 12% to 68% between PRE and POST period.
  
  
  CONCLUSIONS
  After an awareness campaign of the paramedical and medical staff, we succeeded in improving significantly the routine use of analgesics regardless of their level. Nevertheless healthcare professionals still seem reluctant to administer opioids.
authors.affiliation: Département d'anesthésie-réanimation D, pôle naissance et pathologies de le femme, CHU Arnaud-de-Villeneuve, 371, avenue du Doyen-Giraud, 34295 Montpellier, France. paulinederas@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: Deras
authors.forename: A
authors.initials: A
authors.lastname: Bonnal
authors.forename: M
authors.initials: M
authors.lastname: Barbier
authors.forename: E
authors.initials: E
authors.lastname: Morau
authors.forename: P
authors.initials: P
authors.lastname: Colson
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D016362:Analgesia, Obstetrical; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D001942:Breast Feeding; D002585:Cesarean Section / Q000534:rehabilitation; D002921:Cicatrix / Q000503:physiopathology; D004359:Drug Therapy, Combination; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D006801:Humans; D007660:Ketoprofen / Q000008:administration & dosage / Q000627:therapeutic use; D008485:Medical Audit; D051346:Mobility Limitation; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use; D009340:Nefopam / Q000008:administration & dosage / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010361:Patients / Q000523:psychology; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011446:Prospective Studies; D058996:Quality Improvement
chemical_list: D000700:Analgesics; D009294:Narcotics; D000082:Acetaminophen; D009340:Nefopam; D009020:Morphine; D007660:Ketoprofen