{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T23:50:40Z","timestamp":1776901840414,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,2,25]],"date-time":"2017-02-25T00:00:00Z","timestamp":1487980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the efficacy, safety and satisfaction from two modes of oral analgesia administration for the treatment of post\u2010caesarean pain in the first 48\u00a0h following surgery: on\u2010demand versus fixed time interval administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Open label parallel\u2010group, randomised\u2010controlled trial from February to December 2013.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>University\u2010affiliated hospital in Israel.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Two\u2010hundred women who underwent caesarean delivery with regional anaesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were randomly assigned to receive predetermined combinations of tramadol, paracetamol and diclofenac either following patient demand or at predetermined 6\u2010h intervals for the first 48\u00a0h. If the patient requested additional analgesia, Percocet (oxycodone and paracetamol) was given as a rescue treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Pain intensity and satisfaction were self\u2010evaluated with visual analogue scale of 0 (no pain\/least satisfaction) to 10 (worst pain\/highest satisfaction). Breastfeeding, need for supplemental formula, and maternal and neonatal adverse effects were also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The \u2018fixed time interval\u2019 group, compared with the \u2018on\u2010demand\u2019 group, had lower mean pain score (2.8\u00a0\u00b1\u00a00.84 versus 4.1\u00a0\u00b1\u00a00.48, respectively; <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.0001), higher satisfaction rate (9.1\u00a0\u00b1\u00a01.2 versus 8.3\u00a0\u00b1\u00a01.5, respectively; <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.0001), more breastfeeds (23.7\u00a0\u00b1\u00a06.5 versus 19.2\u00a0\u00b1\u00a06.2, respectively; <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.0001) and less use of supplemental formulas (8.2\u00a0\u00b1\u00a05.2 versus 11.9\u00a0\u00b1\u00a06.5, respectively; <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.0001). The number of times that drugs were given was slightly higher in the \u2018fixed time interval\u2019 group without an increase in maternal adverse effects, which were mild. No adverse effects were reported for the neonates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Administration of oral analgesia in fixed time intervals is superior to drug administration following patient demand without increasing maternal or neonatal adverse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Oral analgesia in fixed time intervals is superior to analgesia following demand.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14546","type":"journal-article","created":{"date-parts":[[2017,2,25]],"date-time":"2017-02-25T06:32:57Z","timestamp":1488004377000},"page":"1063-1070","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Fixed time interval compared with on\u2010demand oral analgesia protocols for post\u2010caesarean pain: a randomised controlled trial"],"prefix":"10.1111","volume":"124","author":[{"given":"E","family":"Yefet","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Emek Medical Center Afula Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Taha","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Emek Medical Center Afula Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Salim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Emek Medical Center Afula Israel"},{"name":"Rappaport Faculty of Medicine Technion Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Hasanein","sequence":"additional","affiliation":[{"name":"Neonatology Department Emek Medical Center Afula Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y","family":"Carmeli","sequence":"additional","affiliation":[{"name":"Obstetrical Anesthesiology Unit Department of Anesthesiology Emek Medical Center Afula Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Research Authority Emek Medical Center Afula Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z","family":"Nachum","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Emek Medical Center Afula Israel"},{"name":"Rappaport Faculty of Medicine Technion Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,2,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2008.03.007"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.08.027"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2012.04.012"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2007.00160.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2003.02.012"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-199701000-00024"},{"key":"e_1_2_6_8_1","volume-title":"Pain: Current Understanding of Assessment, Management, and Treatments (Monograph)","author":"National Pharmaceutical Council","year":"2001"},{"key":"e_1_2_6_9_1","first-page":"168","volume-title":"Raising the Standard: A Compendium of Audit Recipes","author":"Pickering EH","year":"2006"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000177100.08599.C8"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.08.014"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.4238\/2014.March.19.4"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-012-2384-5"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.126646"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2010.11.024"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2001.118863"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0261-3794(99)00028-1"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199912000-00045"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2005.04175.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199902000-00018"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2012.02663.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(00)00256-6"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.02.025"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2015.03.006"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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