Relationship Between Pain Severity in Post-Caesarean Section and Its Preoperative Factors

JAI (Jurnal Anestesiologi Indonesia) Pub Date : 2023-11-01 DOI:10.14710/jai.v0i0.57730

Derajad Bayu Atmawan, Hanif Kurniawan, R. I. Estiko, Trisya Allinda

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Abstract

Background: According to the World Health Organization (WHO), the global prevalence of cesarean section (C-section) reaches 21% of all deliveries and is expected to increase to 29% by 2030. This major surgery is associated with moderate to severe postoperative pain. Previous studies have shown that factors such as emergency cases, preoperative anxiety, previous C-sections, length of surgery, type of anesthesia, and pain medication are all important factors contributing to post-C-section pain.Objective: To identify preoperative factors that affect post-cesarean pain, including age, gravida, previous C-section, anthropometry, preeclampsia (PE), fetal malposition, premature rupture of the membranes (PROM), human immunodeficiency virus (HIV), malnutrition, preterm labor, hepatitis B, anemia, and emergency procedure.Methods: A cross-sectional study was conducted at dr. Soehadi Prijonegoro Hospital, Sragen, Indonesia. The inclusion criteria are: (1) willing to participate in this study, (2) age more than 18 years old, (3) cooperative and communicative, and (4) not in disability condition. We analyzed the data using Wilcoxon and Spearman's tests with Statistical Package for the Social Sciences (SPSS) version 25. This research has conducted ethical approval by the Ethics Committee.Results: From 30 subjects, the age spread between 22 to 44 years, with 20% being older than 35 years pregnant women. Most patients experienced moderate (Numeric Rating Scale [NRS] 4 to 6: 60%) and severe pain (NRS 7 to 10: 30%) 12 hours after surgery. While at 24 hours, the majority experienced mild (NRS 1 to 3: 36.7%) to moderate pain (NRS 4 to 6: 46.7%). Our analysis did not identify any preoperative factors significantly related to pain levels after 12- and 24-hours following C-section (p > 0.05).Conclusion: There is no relationship between preoperative factors and postoperative pain. Nonetheless, pain management should be tailored to each patient’s clinical condition.

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剖腹产后疼痛严重程度与术前因素的关系

背景：根据世界卫生组织（WHO）的数据，全球剖腹产（C-section）的发生率占所有分娩的 21%，预计到 2030 年将增至 29%。这种大手术会带来中度到重度的术后疼痛。以往的研究表明，急诊病例、术前焦虑、既往剖腹产、手术时间长短、麻醉类型和止痛药物等因素都是导致剖腹产后疼痛的重要因素：目的：确定影响剖腹产后疼痛的术前因素，包括年龄、孕产妇、既往剖腹产经历、人体测量、子痫前期（PE）、胎位不正、胎膜早破（PROM）、人类免疫缺陷病毒（HIV）、营养不良、早产、乙型肝炎、贫血和紧急手术：这项横断面研究在印度尼西亚斯拉根的 Soehadi Prijonegoro 医院进行。纳入标准为(1)愿意参加本研究；(2)年龄大于 18 岁；(3)合作、善于沟通；(4)无残疾。我们使用社会科学统计软件包（SPSS）25 版对数据进行了 Wilcoxon 和 Spearman 检验。本研究已获得伦理委员会的伦理批准：30 名受试者的年龄介于 22 至 44 岁之间，其中 20% 为 35 岁以上的孕妇。大多数患者在术后 12 小时出现中度疼痛（数值评定量表 4 至 6：60%）和重度疼痛（数值评定量表 7 至 10：30%）。而在 24 小时后，大多数患者会感到轻度（NRS 1 至 3：36.7%）至中度疼痛（NRS 4 至 6：46.7%）。我们的分析没有发现任何术前因素与剖腹产术后 12 小时和 24 小时的疼痛程度有明显关系（P > 0.05）：结论：术前因素与术后疼痛之间没有关系。结论：术前因素与术后疼痛之间没有关系，但疼痛治疗应根据每位患者的临床情况量身定制。

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JAI (Jurnal Anestesiologi Indonesia)

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