With regards to using an On-Q pain pump for incisional pain after cesarean section, I would bet (if I had money, which I don't) that it is bupivicaine or ropivacaine that is being used.  These are used exclusively for delivery of local anesthetic either directly to a surgical site or to a nerve bundle for a peripheral nerve block.  Narcotics are not used in them.  Certain surgeons at my training institution liked them (for some thoracic procedures and open gastric bypass surgeries) but these disposable pumps are *very* expensive and not in widespread use mostly because of cost.  Intriguing idea for c-sections, though....  

And Kathy mentioned the option of CSE (combined spinal-epidural) for c-section, which really can be a very nice way to go.  We haven't clinically appreciated the difference in quality of block between spinal versus epidural for c-section so infrequently use a spinal either alone or with an epidural, but I used to like placing them depending on clinical scenario and OR flow, and especially for moms requesting an epidural who were in considerable pain and progressing quickly in labor.

Not quite sure how to twist this around back towards breastfeeding... :)

Sarah Reece-Stremtan M.D.
Pediatric anesthesiology fellow in Washington DC (who's now hoping for a very quiet night at work but probably just jinxed herself)

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome