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Perioperative caearean section pain management at Groote Schuur hospital ? an audit

Background: Caesarean section is one of the commonest surgeries performed resulting in moderate-to-severe pain in a significant proportion of women. The PROSPECT (procedure specific postoperative pain management) group includes surgeons and anaesthetists who develop procedure-specific consensus reco...

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Main Author: Giles, Daniel
Other Authors: Parker, Romy
Format: Thesis
Language:English
English
Published: Department of Anaesthesia and Perioperative Medicine 2025
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access_status_str Open Access
author Giles, Daniel
author2 Parker, Romy
author_browse Giles, Daniel
Parker, Romy
author_facet Parker, Romy
Giles, Daniel
author_sort Giles, Daniel
collection Thesis
description Background: Caesarean section is one of the commonest surgeries performed resulting in moderate-to-severe pain in a significant proportion of women. The PROSPECT (procedure specific postoperative pain management) group includes surgeons and anaesthetists who develop procedure-specific consensus recommendations on managing postoperative pain. Our audit compared current clinical practice to that recommended by the updated PROSPECT guidelines for caesarean section from 2020. Methods: A cross-sectional observational study was conducted using the PAIN OUT standard operating procedures. The data were collected between 11 February and 5 March 2022 and uploaded onto the PAIN OUT registry. The appropriate data were extracted and used to describe the current standard of care directly against each of the nine interventions recommended by the PROSPECT guidelines. Results: A total of 84 patients were included in the audit. Five of the recommended interventions were not done at all (intrathecal long-acting opioid, preoperative oral paracetamol, intraoperative and postoperative NSAID, intraoperative intravenous dexamethasone), two intraoperative interventions were done poorly (intravenous paracetamol 15.5%, local anaesthetic 15.5%) and two postoperative interventions were done well (oral paracetamol 89.3%, intramuscular morphine 100%). Conclusion: Current clinical practice for the perioperative pain management of caesarean sections at this hospital falls short of best practice as outlined in the PROSPECT guidelines. The introduction of a perioperative protocol, and continuing education of doctors, nurses and patients on pain and its management may be effective ways to improve practice.
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institution University of Cape Town (South Africa)
language English
eng
last_indexed 2026-06-10T12:33:05.164Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2025
publishDateRange 2025
publishDateSort 2025
publisher Department of Anaesthesia and Perioperative Medicine
publisherStr Department of Anaesthesia and Perioperative Medicine
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/41575 Perioperative caearean section pain management at Groote Schuur hospital ? an audit Giles, Daniel Parker, Romy Pain caesarean section perioperative pain management PROSPECT guidelines Background: Caesarean section is one of the commonest surgeries performed resulting in moderate-to-severe pain in a significant proportion of women. The PROSPECT (procedure specific postoperative pain management) group includes surgeons and anaesthetists who develop procedure-specific consensus recommendations on managing postoperative pain. Our audit compared current clinical practice to that recommended by the updated PROSPECT guidelines for caesarean section from 2020. Methods: A cross-sectional observational study was conducted using the PAIN OUT standard operating procedures. The data were collected between 11 February and 5 March 2022 and uploaded onto the PAIN OUT registry. The appropriate data were extracted and used to describe the current standard of care directly against each of the nine interventions recommended by the PROSPECT guidelines. Results: A total of 84 patients were included in the audit. Five of the recommended interventions were not done at all (intrathecal long-acting opioid, preoperative oral paracetamol, intraoperative and postoperative NSAID, intraoperative intravenous dexamethasone), two intraoperative interventions were done poorly (intravenous paracetamol 15.5%, local anaesthetic 15.5%) and two postoperative interventions were done well (oral paracetamol 89.3%, intramuscular morphine 100%). Conclusion: Current clinical practice for the perioperative pain management of caesarean sections at this hospital falls short of best practice as outlined in the PROSPECT guidelines. The introduction of a perioperative protocol, and continuing education of doctors, nurses and patients on pain and its management may be effective ways to improve practice. 2025-08-13T13:04:17Z 2025-08-13T13:04:17Z 2025 2025-08-07T08:46:14Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/41575 en eng application/pdf Department of Anaesthesia and Perioperative Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Pain
caesarean section
perioperative pain management
PROSPECT guidelines
Giles, Daniel
Perioperative caearean section pain management at Groote Schuur hospital ? an audit
thesis_degree_str Master's
title Perioperative caearean section pain management at Groote Schuur hospital ? an audit
title_full Perioperative caearean section pain management at Groote Schuur hospital ? an audit
title_fullStr Perioperative caearean section pain management at Groote Schuur hospital ? an audit
title_full_unstemmed Perioperative caearean section pain management at Groote Schuur hospital ? an audit
title_short Perioperative caearean section pain management at Groote Schuur hospital ? an audit
title_sort perioperative caearean section pain management at groote schuur hospital an audit
topic Pain
caesarean section
perioperative pain management
PROSPECT guidelines
url http://hdl.handle.net/11427/41575
work_keys_str_mv AT gilesdaniel perioperativecaeareansectionpainmanagementatgrooteschuurhospitalanaudit