A recent study published in the “American Journal of Obstetrics and Gynecology” journal demonstrated that incisional infiltration with local anesthetics (such as bupivacaine and adrenalin) is an efficient approach to relieve postsurgery pain and improve satisfaction in pregnant females scheduled to undergo cesarean section. In this randomized controlled trial, researchers aimed to assess the effect of incisional infiltration with local anesthetics to manage postoperative pain.

Two groups were formed with term pregnant women randomized in a 1:1 ratio. Before wound closure in the study group, infiltration of the incision on both sides of the subcutaneous layer was done using a mixture of 30mL of 0.25% bupivacaine and adrenalin in the ratio of 1:200,000, while no infiltration was done in the control group. Out of 288 women, 143 were assigned to the study group and 145 were assigned to the control group.

After 24 hours of admission to the maternity unit, the mean postoperative pain intensity (primary endpoint) was measured by a visual analogue scale (VAS) from 0 to 10 cm, the worst pain recorded was 10. The study group illustrated a lower mean VAS score (Table 1), reduced postpartum use of rescue opioid analgesics, and better satisfaction when compared to the control group.

No considerable differences were observed in demographic as well as obstetric variables between the groups. No variation was found in the length of operation, time to first mobility, length of the stay, and rate of scar hematoma.

Thus, incisional infiltration with single-shot bupivacaine and adrenalin during cesarean section is beneficial to offer postoperative pain relief.