Comparison between the Effect of Rectus Muscle and peritoneum closure Versus Non closure in repeated Caesarean Section on Postoperative Pain: A Randomized Controlled Trial

Aim: To compare the effect of rectus muscle and peritoneum closure versus non closure during repeated Cesarean Section on postoperative pain.Study Design: A prospective, single-blinded, randomized clinical trial.Patients and Methods: It included (n=100) patients who underwent repeated Cesarean section. They were randomly allocated into two groups; Group (A): non-closure of rectus muscle and peritoneum , Group (B): closure . Postoperative pain was assessed by visual analogue scale during hospital stay. Postoperative analgesia, amount of blood loss and occurrence of postoperative complications were also analyzed.Results: Women with non-closure technique had significantly lower visual analogue score (VAS) at the end of 1st 48 hours postoperative (2.86 ± 1.61) in comparison to other group. Women who underwent closure had no difference as regard VAS (4.26 ± 2.19 vs. 4.80 ± 2.36; P value = 0.19). Regarding postoperative analgesia intake, women with non-closure had a significant lower intake of analgesic drugs (170.76 ± 30.85 mg) in comparison to other group.Conclusion: Rectus muscle and peritoneal approximation is associated with significant increase in postoperative pain and analgesia.