Adherence to an intraoperative and post-cesarean analgesia protocol: a before-and-after implementation study in a large academic center (2024–2025)
Authors' conclusion
After implementation of protocols intended to improve post-cesarean analgesia, quasi-universal adherence to the intraoperative multimodal analgesia protocol was achieved within the first three months and was associated with significantly improved pain scores in the post-anesthesia care unit.
Study context
- Population
- Women undergoing term cesarean delivery, May 2024 to July 2025
- Participants
- 202 women
- Exposure
- Pre-implementation vs Post-implementation
- Pre-implementationn = 101reference
- Post-implementationn = 101
- Outcome
- Adherence to the intraoperative anaesthesia protocol and the postoperative nursing protocol
Methodological detailssingle-centre, implementation study, Adherence assessed by investigator-led audits of anaesthetic and electronic medical records
- Single-centre
- Implementation study
- Adherence assessed by investigator-led audits of anaesthetic and electronic medical records
Main finding
As reported in the abstract
Intraoperative adherence by 10 months
96%
Postoperative adherence POD 1
71.3%
Postoperative adherence POD 2
13.9%
Postoperative adherence POD 3
3%
Observational data: associations, not effects.
Secondary outcomes
Pain (VAS >3) in PACU
- Incidence of pain (VAS >3) in PACU decreased from 33.6% to 4%
Postoperative pain (VAS >3), POD 1-3
- Pain (VAS >3) POD 1
- 52.5%
- Pain (VAS >3) POD 2
- 60.4%
- Pain (VAS >3) POD 3
- 24.8%
- Persistently high rates
Original publication
Adherence to an intraoperative and post-cesarean analgesia protocol: a before-and-after implementation study in a large academic center (2024–2025). Int J Obstet Anesth. Published 16 June 2026. doi:10.
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