SynthesisAnaesthesia2026
Pain management after elective caesarean section under neuraxial anaesthesia: an updated systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations.
Synthesis in Anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07777029 (Subcutaneous Methadone for Cesarean Analgesia), which is not on this map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Subcutaneous Methadone for Cesarean Analgesia: A Non-inferiority Study Using Quality of Recovery -10 Score.
Who cites it
4 citing papers in PubMed.
- Ultrasound-Guided Transversalis Fascia Plane Block Versus Transversus Abdominis Plane Block for Postoperative Analgesia After Repeat Cesarean Delivery: A Prospective Observational Study.Healthcare (Basel, Switzerland) · 2026Article
- Intraoperative Transcutaneous Electrical Acupoint Stimulation Attenuates Postoperative Mechanical Pain Sensitization and Visceral Pain After Elective Cesarean Delivery: A Randomized Controlled Trial.Advances in therapy · 2026Article
- Ultrasound-Guided Transversalis Fascia Plane Block Versus Intrathecal Morphine for Post-Cesarean Analgesia: A Prospective Observational Comparative Cohort Study Incorporating a Non-Inferiority Analytical Framework.Journal of clinical medicine · 2026Article
- Ultrasound-guided regional anaesthesia techniques for post-caesarean analgesia: a narrative review of current evidence.Anaesthesiology intensive therapy · 2026Review
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionElective caesarean section is a common and painful procedure. Uncontrolled pain following caesarean section can profoundly and negatively on a wide range of patient and healthcare-centred outcomes. The aim of this systematic review was to update existing recommendations for postoperative pain management after elective caesarean section performed under neuraxial anaesthesia.
methodsA systematic review using the PROcedure SPEcific Postoperative Pain ManagemenT (PROSPECT) methodology was undertaken. Randomised trials evaluating the efficacy of analgesic, anaesthetic and surgical interventions were retrieved. Systematic reviews and meta-analyses of randomised controlled trials were also reviewed. Trials evaluating pain management for emergency surgical deliveries or caesarean section performed under general anaesthesia were not included.
resultsSixty-one randomised controlled trials were included. For patients undergoing elective caesarean section performed under neuraxial anaesthesia, we recommend that clinicians administer intrathecal morphine 50-100 μg or diamorphine 300 μg pre-operatively, and paracetamol, non-steroidal anti-inflammatory drugs and dexamethasone after delivery. If a neuraxial opioid is not administered, clinicians should use one of a range of recommended fascial plane blocks; alternatively, the wound should be infiltrated with local anaesthetic. The postoperative regimen should include regular paracetamol and non-steroidal anti-inflammatory drugs, with opioids used for rescue. The surgical technique should include a Joel-Cohen incision. The peritoneum should not be closed. DISCUSSION: An analgesic regimen to manage pain safely and effectively after elective caesarean section based on up-to-date evidence is presented. Consideration has been given to balancing analgesic efficacy and potential adverse effects. Future research should determine the optimal dose of dexamethasone and epidural long-acting opioid, establish the most effective regional analgesic technique and develop standardised outcome sets to better compare techniques.
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