cesarean section without opiates

[blairsmummy]

Hi there,

I'm having a ceasarean three weeks on Monday with my second child. I had a ceasarean with my son ten years ago. I remember feeling horrible and itchy due to the pain meds and also having horrendous constipation. Also since then I've had two bone surgeries and the morphine just absolutely killed me. I was itching, hallucinating, had insomnia and urinary retention. Even if I take codeine I feel awful. I was wondering if anyone here, particularly if you're in Scotland as that's where I am, has had a c section without any opiates used during or after? If so, what did you have instead? And was the pain bearable?

Any advice would be welcome x

[MissBattleaxe]

If i were you I would ask what other pain relief is available. You do want some pain relief right?

[user1467983757]

What is used in epidural? Sorry I'm a bit ignorant on this.

[MissBattleaxe]

I had an epidural, which wore off during surgery! (ouch) and a spinal, which was a dream. I don't know what's in them, but having had 2 sections I wouldn't recommend having one without robust pain relief.

[hugoagogo]

I was given one morphine injection after having ds- but I got the impression this was a concession to me because I cannot tolerate nsaids. Everyone else on the ward got tonnes of diclafenac (sic). I had to cope with paracetamol after that wore off.
But like user I have not a clue about what is in an epidural?

[blairsmummy]

Yeah I definitely want pain relief, just not opiate based. I think in the epidural they put an anaesthetic and morphine or pethidine. I had diclofenac after my first c section but whatever they put in my spinal was opiate based and made me feel horrible. It might have been pethidine. I'm just hoping there's an alternative to be put in my spinal.

[hugoagogo]

You should discuss it with the anaesthetist, they might be able to give you something to alleviate your other symptoms.

[blairsmummy]

It wore off 😨 oh my goodness that sounds awful! That must have been terrifying. I'm going to ask the anaesthetist on the day about what's available. I'm just thinking about it a lot. I've asked my obstetrician but he's said I'll need to ask on the day. Also, has anyone else had a section without the screen so you can see your baby being delivered?

[ceara]

For a planned section, you'll likely have a spinal not an epidural. There will be an opioid alongside the anaesthetic agent, I think typically morphine, which provides initial post-op pain relief as well as enhancing the block during surgery. (My ELCS was in England but I don't think that makes any difference.) I think it would be very tough indeed for you without the opioid painkiller - a case of the side effects being more than worth it for the pain relief benefits? But you don't have to take any more opiod painkillers while you recover unless you feel you need them. (i was told that I could have oramorph post-surgery but I honestly didn't need it - was fine with paracetamol/ibuprofen.)

[ceara]

Just seen your latest post OP. I had a pre-op appointment a couple of days before which I think is standard, when I also saw the anaesthetist. So you might have chance to discuss it then?

I had the screen up but they'd have lowered it when my baby was lifted out if I'd wanted - I was too squeamish so said no!

[blairsmummy]

Sorry I meant spinal not epidural. Yeah I'm thinking if I'm in too much pain I might not be able to cope very well and so that could be detrimental to bonding with the baby. It may end up that I have to have the strong painkiller in the spinal and just deal with the side effects. Just thought I'd see if there was anyone at all that hadn't had it, but I've not met or spoken to anyone so far. Thanks so much for all the replies.

[MangoMoon]

I cannot tolerate opiates either OP.
After every surgery I've had, I have to make the choice between whether to put up with a level of pain or to feel like I'm literally dying on opiates.

I usually take the morphine option for the first 12 - 24 hours as I mostly sleep during that time & then switch to paracetamol as soon as poss after.
I've had 2 c sections & 2 other major stomach surgeries where I've chosen the pain over the morphine within 24 hours; I've a v high pain threshold though so am happier to do that.

[hugoagogo]

Oh god no, it didn't wear off during surgery!
Iirc I had it the following morning after ds was delivered about midnight, it wore off a few hours after that.
One of my enduring memories of both my cs was how wonderful the anaesthetist was, mine really listened and made me feel that my feelings and wellbeing were his top priority. Both mine were emergencies too, but I still had the chance to talk to him about my worries.
Good luck

[blairsmummy]

Hogoagogo oh right! Phew! Yeah I had a lovely anaesthetist with my last leg op and he gave me a twelve hour leg block so that I didn't have to use the morphine pump nearly as much as the first op.I'll just have to wait and see what happens. It's all worth it in the end though 😍 MangoMoon it's horrid eh? Absolutely hate any form of opiate.

[Mummyme87]

You will probably be offered a CSE which is a combined spinal epidural and use bupivicaine and not fentanyl. Possibly keep epidural catheter in afterwards and use levobupivicaine for the first 12-24hrs post birth for analgesia

[SockQueen]

Not everywhere uses CSEs, Mummyme, and a plain levobupivicaine regime post-op would be unusual in my experience, though it is a possible option.

OP, a spinal for an ELCS would normally contain an opioid, usually either fentanyl or diamorphine. These are less bad for itching than morphine but it is still a side effect for some. Post-op regular paracetamol and ibuprofen/diclofenac is a good start, but most women need at least some stronger analgesia on top of that. If you really can't manage with morphine, then there are alternatives you can ask about, like oxycodone, but different hospitals will have different things available. Talk to your anaesthetist.

[SockQueen]

Forgot to say - the spinal can be done without opioid, so it's just local anaesthetic, and it will work for the operation, but post-op pain relief will be worse.

[pitterpatterrain]

Thanks this is really interesting - I had a similar question. I am waiting for my old notes to confirm (hopefully) what I was given so that I can have this discussion

[blairsmummy]

Thanks for the replies everyone. I'm definitely going to ask about all of these options. I have to go to the hospital for blood tests the day before the c section so I'll see if I can get a chance to speak to the anaesthetist then.

[gingerboy1912]

Tramadol

[Mumoftwoyoungkids]

I had a massive PPH and post section my breathing / blood pressure was very very low. (Ie close to non existent.) They didn't / couldn't give me any kind of opiate as they were worried it would -well - kill me.

I was drifting in and out and don't really remember.

Probably not the best route to take......

[blairsmummy]

Wow scary stuff Munoftwoyoungkids 😨 hope you're ok now with no lasting effects.

I can't even tolerate Tramadol gingerboy1912. Tried that after leg ops. Horrible stuff.

[blairsmummy]

I've decided I'm going to ask to speak to an anaesthetist as soon as possible when I have my 36 week scan and consultant appointment on Tuesday.