Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients

Cesarean section (CS) is the most widely performed and one of the most painful surgeries. This study investigated postoperative pain after CS using patient-related outcomes (PROs) to identify risk factors for severe pain. The secondary outcome was to evaluate the influence of surgery indication (pri...

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Bibliographic Details
Published in:Journal of clinical medicine 2023-11, Vol.12 (22), p.6999
Main Authors: Emrich, Norah L. A., Tascón Padrón, Laura, Komann, Marcus, Arnold, Christin, Dreiling, Johannes, Meißner, Winfried, Strizek, Brigitte, Gembruch, Ulrich, Jiménez Cruz, Jorge
Format: Article
Language:English
Subjects:
Analgesics
Breastfeeding & lactation
Cesarean section
Chronic pain
Clinical medicine
Clinical outcomes
Cohort analysis
Ethics
Gynecology
Narcotics
Obstetrics
Pain
Pain management
Patients
Quality improvement
Questionnaires
Registration
Statistical analysis
Surgery
Women
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Summary:Cesarean section (CS) is the most widely performed and one of the most painful surgeries. This study investigated postoperative pain after CS using patient-related outcomes (PROs) to identify risk factors for severe pain. The secondary outcome was to evaluate the influence of surgery indication (primary CS (PCS) vs. urgent CS (UCS)). This multi-center, prospective cohort study included data submitted to the pain registry “quality improvement in postoperative pain treatment” (QUIPS) between 2010 and 2020. In total, 11,932 patients were evaluated. Median of maximal pain was 7.0 (numeric rating scale (NRS) 0 to 10); 53.9% suffered from severe pain (NRS ≥ 7), this being related to impairment of mood, ambulation, deep breathing and sleep, as well as more vertigo, nausea and tiredness (p < 0.001). Distraction, relaxation, mobilization, having conversations, patient-controlled analgesia (PCA) and pain monitoring were shown to be protective for severe pain (p < 0.001). Maximal pain in PCS and UCS was similar, but UCS obtained more analgesics (p < 0.001), and experienced more impairment of ambulation (p < 0.001) and deep breathing (p < 0.05). Severe pain has a major effect on daily-life activities and recovery after CS, and depends on modifiable factors. More effort is needed to improve the quality of care after CS.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm12226999