Factors Affecting Post Caesarean Pain Intensity among Women in the Northern Peninsular of Malaysia

Jasim, Hanan Hussein; Sulaiman, Syed Azhar Syed; Khan, Amer Hayat; Usha, A. P.; Rajah, P S

doi:10.7860/jcdr/2017/25364.10630

Cited by 20 publications

(17 citation statements)

References 24 publications

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“…The post-cesarean section pain is characterized as acute and is closely related to the damage caused to the tissue due to the inflammatory reactions derived from a traumatic operation. Even resenting a universal incident, the post-cesarean section pain is frequently ignored, which may affect the patient's satisfaction and decrease her quality of sleep (Jasim et al, 2017& de Sousa et al, 2009.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Progressive Muscle Relaxation on Post Cesarean Section Pain, Quality of Sleep and Physical Activities Limitation

Ismail¹,

Elgzar²

2018

IJSN

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Background: Pain, sleep disturbances, and physical activity limitation are the most tiresome complains of the women post caesarian section (Cs). Progressive muscle relaxation is a promising intervention for these complains. This study aimed to determine the effect of progressive muscle relaxation technique on post-cesarean section pain, quality of sleep and physical activities limitation. Research design: Randomized controlled clinical trial. Setting: post-partum unit at Damanhour National Medical Institute. Sample: A purposive sample of 80 women undergoing Cs was recruited. Randomization block was done to randomly assign 40 women for the study group and 40 for the control group. Tools: Four tools were used for data collection: structured interview schedule, short-form McGill Pain Questionnaire, Physical activities limitation Questionnaire and Groningen Sleep Quality Scale. Results: After the intervention, PMR significantly decreased pain severity among study group in Pain Rating Index scale, Visual analogue pain scale, and Present Pain Intensity scale compared to the control group. The severe physical activities limitation significantly absent from the entire study group, while it was significantly present among 70% of the control group. About two-thirds (62.5%) of the study group had a good quality of sleep compared to 5% of the control group. Conclusion: PMR significantly decreased pain, improved physical activities and quality of sleep among women after Cs. Recommendation: PMR should be incorporated in the nursing intervention protocols post-Cs.

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Section: Introductionmentioning

confidence: 99%

The Effect of Progressive Muscle Relaxation on Post Cesarean Section Pain, Quality of Sleep and Physical Activities Limitation

Ismail¹,

Elgzar²

2018

IJSN

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“…The development of pain post-CD is widely variable. Multiple factors have been associated with this development including higher body mass index, longer operative time, general anesthesia vs. spinal, age, marital status, hospital stay, and age [15]. This project is the first to suggest a difference in postoperative opioid requirements between patients undergoing primary versus repeat CD.…”

Section: Discussionmentioning

confidence: 92%

Comparison of Postoperative Opioid Consumption and Pain Scores in Primary Versus Repeat Cesarean Delivery in Opioid Naïve Patients

Chao

Pasca

Alschuler

et al. 2019

JCM

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Background: Cesarean deliveries represent a large percentage of deliveries worldwide. Patients undergoing repeat cesarean deliveries are known to have increased risks for surgical complications. However, little is known regarding potential differences in pain. We sought to compare postoperative opioid consumption and pain scores in opioid naïve patients undergoing primary versus repeat non-emergent cesarean delivery. Methods: This was a retrospective cohort study. Patient inclusion criteria included: having a non-emergent cesarean delivery, receiving a spinal procedure for surgical anesthesia without general anesthesia, and following the same postoperative pain management protocols. Exclusion criteria included: history of opioid tolerance, illicit drug use, or prior, non-obstetric, major abdominal surgery. The primary outcome marker was total morphine equivalents consumed 0–72 h post-procedure compared between the primary versus repeat cesarean delivery groups. Secondary outcome markers were opioid consumption and pain scores in 24-h period increments for the first 72 h postoperatively. Results: 1617 patients were screened. 217 primary and 377 repeat cesarean deliveries met criteria for comparison. Reduced opioid consumption was demonstrated for the total opioid consumption 0–72 h for the repeat cesarean delivery group (median = 35) compared to the primary cesarean delivery group (median = 58), p = 0.0005. When divided into 24-h periods, differences were demonstrated for the 24–48 and 48–72 h periods but not the 0–24 h period. Pain scores did not differ statistically. Conclusion: Opioid naïve obstetric patients who undergo non-emergent repeat cesarean delivery demonstrate lower opioid consumption in the postoperative period. Providers should be aware of this potential difference in order to better educate patients and provide adequate pain management. Highlights: The study reviewed differences in opioid consumption between primary and repeat cesarean deliveries. All patients received the same protocol for spinal dosage and pain management. Repeat cesarean deliveries were associated with lower opioid consumption.

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“…Acute postsurgical pain has been associated with patient (e.g., age, preexisting psychiatric diagnoses, body mass index, smoking status), surgical (e.g., planned versus unplanned CD, primary versus repeat CD, operative time), and anesthetic (general versus regional anesthesia) factors [4][5][6][7][8][9]. Pre-procedural identification of women at increased risk for pain following CD can be used to optimize analgesia and potentially attenuate development of chronic effects [10].…”

Section: Introductionmentioning

confidence: 99%

Labor prior to cesarean delivery associated with higher post-discharge opioid consumption

et al. 2021

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Background Severe acute post-cesarean delivery (CD) pain has been associated with an increased risk for persistent pain and postpartum depression. Identification of women at increased risk for pain can be used to optimize post-cesarean analgesia. The impact of labor prior to CD (intrapartum CD) on acute post-operative pain and opioid use is unclear. We hypothesized that intrapartum CD, which has been associated with both increased inflammation and affective distress related to an unexpected surgical procedure, would result in higher postoperative pain scores and increased opioid intake. Methods This is a secondary analysis of a prospective cohort study examining opioid use up to 2 weeks following CD. Women undergoing CD at six academic medical centers in the United States 9/2014-3/2016 were contacted by phone two weeks following discharge. Participants completed a structured interview that included questions about postoperative pain scores and opioid utilization. They were asked to retrospectively estimate their maximal pain score on an 11-point numeric rating scale at multiple time points, including day of surgery, during hospitalization, immediately after discharge, 1st week, and 2nd week following discharge. Pain scores over time were assessed utilizing a generalized linear mixed-effects model with the patient identifier being a random effect, adjusting for an a priori defined set of confounders. A multivariate negative binomial model was utilized to assess the association between intrapartum CD and opioid utilization after discharge, also adjusting for the same confounders. In the context of non-random prescription distribution, this model was constructed with an offset for the number of tablets dispensed. Results A total of 720 women were enrolled, 392 with and 328 without labor prior to CD. Patients with intrapartum CD were younger, less likely to undergo repeat CD or additional surgical procedures, and more likely to experience a complication of CD. Women with intrapartum CD consumed more opioid tablets following discharge than women without labor (median 20, IQR 10–30 versus 17, IQR 6–30; p = 0.005). This association persisted after adjustment for confounders (incidence rate ratio 1.16, 95% CI 1.05–1.29; p = 0.004). Pain scores on the day of surgery were higher in women with intrapartum CD (difference 0.91, 95% CI 0.52–1.30; adj. p = <0.001) even after adjustment for confounders. Pain scores at other time points were not meaningfully different between the two groups. Conclusion Intrapartum CD is associated with worse pain on the day of surgery but not other time points. Opioid requirements following discharge were modestly increased following intrapartum CD.

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Factors Affecting Post Caesarean Pain Intensity among Women in the Northern Peninsular of Malaysia

Cited by 20 publications

References 24 publications

The Effect of Progressive Muscle Relaxation on Post Cesarean Section Pain, Quality of Sleep and Physical Activities Limitation

The Effect of Progressive Muscle Relaxation on Post Cesarean Section Pain, Quality of Sleep and Physical Activities Limitation

Comparison of Postoperative Opioid Consumption and Pain Scores in Primary Versus Repeat Cesarean Delivery in Opioid Naïve Patients

Labor prior to cesarean delivery associated with higher post-discharge opioid consumption

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