COMPARISON OF OPERATIVE TIME, POSTOPERATIVE PAIN AND CONSUMPTION OF ANALGESIA IN JOEL COHN VERSUS PFANNENSTEIL INCISION FOR LOWER ABDOMINAL CESAREAN SECTION

Background: Cesarean section is one of the most frequently performed major abdominal surgeries worldwide, playing a vital role in ensuring maternal and fetal safety during high-risk deliveries. With rising cesarean rates, optimizing surgical techniques has become increasingly important to improve maternal outcomes. Among the various types of abdominal incisions used, the Joel-Cohen and Pfannenstiel approaches are commonly practiced, each with distinct procedural characteristics and postoperative outcomes. Comparative studies are essential to identify the most efficient and least morbid option for routine obstetric care. Objective: To compare the Joel Cohen and Pfannenstiel incisions in terms of operative time, postoperative pain, and analgesic consumption in women undergoing lower segment cesarean section. Methods: This randomized experimental study was conducted over 12 months at the Department of Obstetrics and Gynecology, Lahore General Hospital. A total of 70 women undergoing primary lower segment cesarean section at >37 weeks of gestation were enrolled and randomly assigned to two equal groups. Group A underwent cesarean delivery via Joel-Cohen incision, while Group B received Pfannenstiel incision. Postoperative pain was measured at 6 and 12 hours using a visual analogue scale (VAS). Total analgesic consumption within the first 12 hours was also recorded. Data were analyzed using SPSS v23 with a significance level set at p<0.05. Results: The mean operative time was significantly shorter in the Joel-Cohen group (3.48 ± 0.61 minutes) compared to the Pfannenstiel group (3.97 ± 0.78 minutes; p = 0.005). Pain scores at 6 hours (6.60 ± 0.69 vs. 7.34 ± 0.76; p < 0.001) and 12 hours (2.34 ± 0.48 vs. 3.34 ± 0.64; p < 0.001) were lower in the Joel-Cohen group. Mean analgesic consumption was also reduced (106.28 ± 9.42 mg vs. 125.71 ± 8.84 mg; p < 0.001). Conclusion: The Joel-Cohen incision significantly reduced operative time, postoperative pain, and analgesic requirements compared to the Pfannenstiel incision, indicating its potential as a preferred technique for lower segment cesarean section.