For women at risk for pain and depression in the months following a cesarean delivery, adding more pain medicine during the operation may help, according to a small study presented at the annual meeting of the Society for Obstetric Anesthesia and Perinatology (SOAP).


All of the 50 women included in the study were considered to be at risk for experiencing relatively high levels of pain immediately after the procedure, as well as pain and depression two months later.
But when half of the women received twice the dose of intrathecal morphine (300 mcg) during the operation, as well as 1 g of acetaminophen (equivalent to two extra-strength Tylenol) every six hours for 24 hours in the recovery room, they experienced significantly less pain on movement and at rest, and had lower pain scores overall, 24 hours after the operation (abstract 87).
“There does seem to be value in identifying patients who are likely to have increased pain requirements, and not treat all comers the same way,” said study author Robert Fish, MD, obstetric anesthesia fellow at Wake Forest University in Winston-Salem, N.C.
Dr. Fish and his team selected their subjects based on their responses to three questions: How much do you expect to hurt after this surgery? How anxious are you about this surgery? How much pain medicine will it take to treat your pain after surgery?