Abdominal irrigation during cesarean section: is it beneficial for the control of postoperative pain and gastrointestinal disturbance? A randomized controlled, double-blind trial

Objectives: We aimed to investigate the efficacy of intraabdominal irrigation with warm saline on pain management and gastrointestinal functions in the postoperative period among patients that underwent cesarean section under spinal anesthesia. Material and methods: Ninety-one women who underwent cesarean section under spinal anesthesia were enrolled in our study. Patients were allocated to either the intraabdominal saline irrigation (n: 46) or the no-irrigation (n: 45) groups by simple randomization prior to cesarean section. A standard surgical technique was used for cesarean delivery. After closure of the hysterotomy, routine abdominal cleansing was performed in both of the groups. Irrigation was performed in the experimental group, not simultaneously but after the routine abdominal cleansing, paying strict attention to avoiding contact with the bowels. The patients were questioned regarding complaints of nausea, vomiting, time of passing gas and highest pain scores at the postoperative time periods of 0 to 3, 3 to 6, 6 to 12 and 12 to 24 hours. Results: Intraabdominal irrigation performed in patients after cesarean delivery exhibited statistically significant shorter postoperative flatulence times and longer operation times in our study. Although there is not a statistically significant difference, we found increased nausea-vomiting rates and a greater need for antiemetic drugs in the saline irrigation group compared to the control group. The postoperative VAS scores were similar in the two groups. Conclusions: We do not suggest routine intraabdominal saline irrigation during cesarean section for postoperative pain control and relief of gastrointestinal disturbance. Irrigation may be performed for the purpose of removing the fetal debris in cesarean deliveries with meconium and dense vernix caseosa to avoid meconium/vernix caseosa peritonitis, which have been widely mentioned in the literature.