The aim of this study is to determine the effect of intra abdominal wall infiltration with bupivacaine to reduce post operative diclofenac need in elective cesarean sections. Inclusion criteria were: women with first single term pregnancy who are candidate for elective caesarean section, spinal anaesthesia, BMI between 20 to 25 before pregnancy, and time of surgery less than 40 minutes. Exclusion criteria were: bleeding, atonia or any unpredicted accident during or after surgery. fannenstiel incision, opium consumption, underlying disease, history of previous abdominal surgery, sensitivity to amid drugs.
In this double- blind, placebo-controlled trial, 60 healthy women with single term pregnancy, after obtaining written informed consent, were randomized into two groups. Patients underwent spinal anesthesia, and then they received a combination of 30cc of 0.25% bupivacaine with 1.5cc of 1:200000 epinephrine as intra abdominal wall infiltration or equal volume of saline in cesarean section at the time of abdominal closure. Pain was assessed using a visual analogue scale 1, 2, 3, 4, 8 and 12 h after the operation. Also mean diclofenac consumption was assessed during 12 h after the operation.
The final analysis was done with statistical tests including Chi Square, Non Parametric test and Mann-withny U by SPSS (P<0.05 was considered significant). Mean pain scores after the operation and mean diclofenace consumption in 12 h were compred between two groups. Also the time we prescribed diclofenac was compared between two groups.