Choosing a method of analgesia of the anterior abdominal willin patients after surgical delivery

Objective. The research goal was to substantiate the optimal choice of multimodal anesthesia of patients in the early recovery period after operative delivery to improve rehabilitation, reduce complications and improve the quality of life of parturient women and newborns.

Materials and methods. An open-label prospective randomized research was held, during which the data of clinical examination, the results of laboratory and instrumental methods of diagnosis and dynamic observation of 310 parturient women and newborns were analyzed. Patients and newborns were divided into three groups. In the main group (n=112), cesarean section was performed for parturient women under epidural anesthesia, which was prolonged in the first three days of the postoperative period. In the comparison group (n=95), the operation was performed under combined spinal-epidural anesthesia, and prolonged epidural anesthesia was used in the first three days of the postoperative period. In the control group (n=103), the operation was performed under epidural anesthesia, and in the postoperative period, nonsteroidal anti-inflammatory drugs (NSAIDs) were used for anesthesia.

Results. It was found that the combination of epidural anesthesia during labor and prolonged epidural anesthesia with ropivocaine in the first three days after cesarean section has a stronger analgesic effect compared to the combination of combined spinal-epidural anesthesia of bipuvacaine during labor and prolonged anesthesia of ropivocaine in the postpartum period, as well as in comparison with the combination of epidural anesthesia of ropivocaine in labor and NSAIDs in the first three days of the postoperative period. Prolonged epidural anesthesia significantly reduced stress hormone levels in both the mother and the newborn during the first 24 hours after surgery and had no negative effects on the newborn.