Did you have morphine for pain relief after your c section?

[Cinai2]

I think some hospitals seem to use it, others don’t. Did you have it / needed it / any side effects?

Haven't seen an open appendix in an adult in 9y of anaesthetics doing about 5 a week every week (often the default in kids)

PR works better for many conditions (kidney stones is the best eg) ... all depends on drug bioavailability - eg rectal paracetamol exists but we v v rarely use it as its so unpredictable in its absorption

@Destiny123 hence why I asked as that poster said it was 15 yrs ago. Mine was 20 yrs ago & was open.

Both, tried keyhole and then had to switch to open.

@Destiny123 My epidural was left in for 3 days, private hospital in the UK.

Makes sensez as we leave them in for up to 5d in major abdominal cancer surgeries etc

but in the nhs labour ward we want people up and about mobilising and home with their babies....Unless you had a major complication or are staying in for baby (scbu or feeding help etc) it would be incredibly rare to even be in the hospital on d3 and definitely not "medicalised' with an epidural

You need a higher level of staffing on the ward to keep the epidural in because of the frequent vital signs checks needed etc. So not generally possible in an NHS setting.

I went for private so I could have an elective CS with no argument and keep my epidural in for three days, among other reasons. It worked very well for me.

I didn’t. I had a massive PPH and my blood pressure was already dangerously low and they couldn’t risk it going any lower.

This was my setup (London, 2022). Apart from ibuprofen which I can’t tolerate.

But, on the ward I got severe referred pain in my shoulder from trapped wind that was so intense it sent me into shock. No amount of the bloody ‘preventative’ peppermint tea and tablets, or Deflatine I took would’ve stopped that. I think it was because my section took ages because I had bronchitis at the time. Had to stay another night because of it all. 🥴 Anyway, I got morphine for that, quick smart. Thank god. For the actual section I was fine with regular paracetamol. Got dihydracodeine for hometime but I got the feeling it was because of the referred pain incident.

It's not purely that at all. We don't want any direct paths from the outside world to the epidural space available to get infected, that are unnecessary. If you get a CNS infection it can be catastrophic, and that level of pain relief just isnt needed for a pfannenstiel incision... and they're not without their risks (urinary retention/low blood pressure/reduced mobilisation so increased risk of blood clots/chest infections etc

I certainly wouldn't elect to have a post op epidural and I'm one of the biggest epidural advocates going. It's rare to even be in hospital beyond the afternoon of day2, let alone needing an epidural

OK well, I was told it was a staffing issue. I wasn't actually asked at any stage if I wanted it to stay in or not (although I knew I did), it just happened. Luckily no complications of that or the surgery. I had a fantastic birth experience.

I was in the USA for my repeats, so the staffing levels were quite good and I don't think that was a concern with the choice of post-op pain relief. My understanding (had a convo with this at pre-op anaesthesia consult, as they were surprised at me getting a combined spinal-epidural for an emergency no-labour section) is that although the epidural can be used for post-op analgesia, they still prefer a straight spinal for a CS unless the epidural has already been placed for labour. The spinal is simpler to do and has a lower chance of spots of poor coverage.

Yep. Pretty much that. Spinals are a tiny needle, epidurals are big needles so have a higher rate of headaches post op when using 2 needles than one (the headaches are v debilitating)

We only tend to do CSEs (combined spinal epidurals) for elective csections for those we expect to have a long surgical time, so if its their 3rd+ section, so they'll be lots of scar tissue to cause surgeons difficulties and so if the spinal wears off, we can topup the epidural mid-op so mum doesn't need a mid-op GA (tbh I've done lots of cses and never needed the epidural).

Or if mum's BP (with preeclampsia) is v high and we want the epidural post-op for its side effects of dropping blood pressure.

Or v rarely someone on long term massive doses of opiates at home, so going to have difficulties managing their post op pain

... I v occasionally do CSEs in the room for labour if the lady is struggling so much that they can't sit still enough to have an epidural without risking nerve injury, where we do a low dose spinal first to make them more comfortable to be able to sit still. Some hospitals do CSEs on all labouring patients as by piercing the dura (cling film around the brain and spinal cord) there's also some intrathecal spread of the epidural mix and hence potentially slightly better pain relief. Epidural still comes out when baby does though