Table 2.
Analgesic interventions that are not recommended for pain management in patients undergoing elective caesarean section.
| Intervention | Reason for not recommending | |
|---|---|---|
| Pre‐operative | Gabapentinoids | Limited procedure‐specific evidence and concerns of side‐effects |
| Intra‐operative | Intravenous ketamine | Limited procedure‐specific evidence and concerns of side‐effects |
| Intravenous dexmedetomidine | Limited procedure‐specific evidence and concerns of side‐effects | |
| Intravenous tramadol and butorphanol | Limited procedure‐specific evidence | |
| Neuraxial clonidine | Inconsistent procedure‐specific evidence and concerns of side‐effects | |
| Neuraxial dexmedetomidine | Inconsistent procedure‐specific evidence and concerns for side‐effects | |
| Intrathecal buprenorphine | Limited procedure‐specific evidence | |
| Epidural hydromorphone | Limited procedure‐specific evidence | |
| Intrathecal midazolam | Limited procedure‐specific evidence and concerns of side‐effects | |
| Intrathecal neostigmine | Concerns of side‐effects | |
| Intrathecal ketamine | Limited procedure‐specific evidence and concerns of side‐effects | |
| Intraperitoneal local anaesthetic | Lack of procedure‐specific evidence | |
| Topical skin analgesia | Lack of procedure‐specific evidence | |
| Clonidine added to TAP | Lack of procedure‐specific evidence | |
| Dexmedetomidine added to TAP | Limited procedure‐specific evidence | |
| Fentanyl added to TAP | Lack of procedure‐specific evidence | |
| Rectus sheath block | Lack of procedure‐specific evidence | |
| Field block | Lack of procedure‐specific evidence | |
| Music | Limited procedure‐specific evidence | |
| Postoperative | Skin‐to‐skin contact | Limited procedure‐specific evidence |
| Intravenous lidocaine | Lack of procedure‐specific evidence | |
| Patient controlled epidural analgesia | Limited procedure‐specific evidence and concerns of side‐effects | |
| Surgical technique | Method of incision: diathermy | Inconsistent procedure‐specific evidence |
| Absence of a bladder flap | Limited procedure‐specific evidence | |
| Blunt fascial opening | Limited procedure‐specific evidence | |
| Uterine exteriorisation | Inconsistent procedure‐specific evidence | |
| Skin incision lasering postoperatively | Limited procedure‐specific evidence | |
| Type of skin closure | Lack of procedure‐specific evidence | |
| Vaginal cleansing | Lack of procedure‐specific evidence | |
| Cervical dilation | Inconsistent procedure‐specific evidence | |
| Type of pyramidalis muscle dissection | Lack of procedure‐specific evidence | |
| Rectus muscle re‐approximation | Limited procedure‐specific evidence |
TAP, transversus abdominis plane block.