Post-cesarean Pain Control Via Continuous Infusion of Ropivacain et Diclogenac Into the Wound Versus Intathecal Morphine

Post-cesarean Pain Control Via Continuous Infusion of Ropivacain et Diclogenac Into the Wound Versus Intathecal Morphine: Comparison of the Quality of Analgesia, Side Effects, and the Incidence of Residual Scar Pain

The goal is to compare the quality of post-cesarean analgesia, the side effects and the incidence of residual scar pain obtained with intrathecal morphine (reference treatment) or with a continuous intra-wound solution including both ropivacain and diclofenac (experimental treatment).

Inclusion Criteria:

• single, normally progressing pregancy
• term > 36 weeks amenorrhea
• BMI between 20 and 25 kg/m^2 before pregnancy
• height between 55 and 90 kg
• cesarean section by Joel-Cohen or Pfannenstiel techniques
• patient has signed consent
• patient has social security coverage

Exclusion Criteria:

• Multiple pregnancy
• pathological pregnancy: hypertension (>140/90 mmHg found during the pregnancy), pre-eclampsia, gestational diabetes
• term < 36 weeks amenorrhea
• non-pregnancy related maternal pathology (insufficiency)
• obesity (BMI > 25 kg/m^2 before pregnancy)
• height < 155 cm or > 180 cm
• weight < 55 kg or > 90 kg
• patient refuses to sign consent
• surgical technique other than Joel-Cohen or Pfannenstiel
• hepatic insufficiency (prothrombin < 60%)
• contra-indications for rachianesthesia: infection, hemostasis problems (platelets < 80.109/L, prothrombin < 60%, TCA > 40s)
• allergy to local anesthestics
• patient is participating in another study, or has participated in another study within the last 6 months
• patient is under any type of guardianship