Tropical Doctor > Volume 39, Number 4 > Pp. 217-221

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Postoperative analgesia following caesarean deliveries in a rural health district of South Africa

M F Khan MBBS MMed   ^*   O B Omole MBBS MCFP       G J O Marincowitz MFamMed MD   

^* Department of Health, Mpumalanga Province; Department of Family Medicine, University of Witwatersrand, Johannesburg; Department of Family Medicine, University of Limpopo, South Africa

Correspondence to: Dr O B Omole, Department of Family Medicine, University of Witwatersrand, Johannesburg, South Africa Email: omole1{at}absamail.co.za

The under-treatment of postoperative pain is prevalent worldwide. This cross-sectional study examined general practitioners' (GPs) knowledge and practices regarding postoperative analgesia in Caesarean deliveries. Postoperative analgesia was said to ensure that patients were pain-free (38.7%), achieved early mobilization (19.4%) and enabled early breast feeding (16%). Pethidine was the opioid of choice; normally prescribed eight hourly (69%) and was combined with non-steroidal anti-inflammatory drugs (NSAID) by 48.6% of doctors and used solely by 51.6%. The prescription of analgesics was mainly influenced by drug availability (45.2%) and potency (19.4%). Most doctors (93.5%) had never attended a pain management course or used pain scores. Doctors at level 1 hospitals were less likely to use pethidine in combination with NSAID (odds ratio: 0.11; confidence interval: 0.02–0.59) compared to those in the specialized hospital. The GPs recognized the importance of postoperative analgesia, but their practices made patients vulnerable to pain after caesarean section.

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