Factors associated with post-cesarean pain
Keywords:
cesarean section; postoperative pain; pain score; associated factor.Abstract
OBJECTIVE
To evaluate the pain pattern and associated factors of pain after cesarean delivery under spinal anesthesia.
METHODS
A cross-sectional study was conducted with term pregnant women who underwent cesarean delivery under spinal anesthesia using 0.5% bupivacaine plus morphine. The participants received postoperative intravenous opioids using patient-controlled anesthesia (PCA). The pain scores were assessed at 12, 20 and 24 hours. The time and amount of opioid use by PCA were recorded. The participants who had a pain score >4, or who needed additional PCA opioid in the first 24 hours were defined as moderate to severe pain group. The possible associated factors were compared between groups.
RESULTS
A total of 100 participants were included in this study. Of these, the intravenous morphine by PCA was used in 8.0%, 38.0% and 54.0% in the first 2, 12 and 24 hours, respectively, after cesarean delivery. The mean of intravenous morphine used was 4.4 mg. The mean pain score at 12, 20 and 24 hours were 2.7, 2.5 and 2.3, respectively. Moderate to severe pain occurred in 66.0% of the participants and 57.0% had a pain score >4 within 24 hours. An associated factor of pain was the use of an oral analgesic drug (adjusted odds ratio 0.29; 95% confidence interval, 0.10 to 0.80; P<0.05).
CONCLUSION
Nearly two-thirds of patients had moderate to severe pain after cesarean delivery under spinal anesthesia using bupivacaine with intrathecal morphine. The use of oral analgesic drugs is an associated factor to reduce pain after cesarean delivery.
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