Predicting the Severity of Acute Pain after Cesarean Delivery: A Narrative Review.

IF 3.2 2区 医学 Q2 CLINICAL NEUROLOGY
Lisa Sangkum, Theerawat Chalacheewa, Choosak Tunprasit, Phisut Lavanrattanakul, Henry Liu
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Abstract

Purpose of the review: Cesarean delivery is one of the most common surgical procedures performed worldwide. Approximately 28-78% of the patients have reported experiencing severe pain after Cesarean delivery, which is associated with adverse outcomes. Current analgesic management strategies employ a one-size-fits-all approach, which may not be suitable for all post-Cesarean patients. Our ongoing research and the purpose of this review are focusing on preoperative risk assessment to identify patients at risk of severe pain or needing higher doses of opioid or other analgesics.

Recent findings: Recent clinical investigations have found that by utilizing the demographic and psychological evaluations, screening tests, quantitative sensory testing, and assessment of response to local anesthetic infiltration, clinicians were potentially able to stratify the risks for severe post-cesarean pain. Several modalities demonstrated significant correlations with pain outcomes, although most of these correlations were weak to modest. Since consensus statement regarding predicting post-CD pain control are still lacking, these correlations can be clinically helpful. It is possible to identify patients at high risk of developing severe acute pain after cesarean section by preoperative demographic data, screening questionnaires, or other tools. Further studies are needed to identify additional variables or screening tools for more accurate prediction and investigate whether personalized analgesic regimens can lead to improved analgesic outcomes.

预测剖腹产后急性疼痛的严重程度:叙述性综述。
审查目的:剖宫产是全球最常见的外科手术之一。据报道,约有 28-78% 的患者在剖宫产术后感到剧烈疼痛,这与不良预后有关。目前的镇痛管理策略采用的是 "一刀切 "的方法,但这种方法可能并不适合所有剖宫产术后患者。我们正在进行的研究和本综述的目的都集中在术前风险评估上,以确定有严重疼痛风险或需要较大剂量阿片类或其他镇痛药的患者:最近的临床研究发现,通过利用人口统计学和心理评估、筛查测试、定量感觉测试以及对局部麻醉剂浸润反应的评估,临床医生有可能对剖腹产后严重疼痛的风险进行分层。有几种模式与疼痛结果有明显的相关性,尽管这些相关性大多较弱或不明显。由于关于预测剖腹产后疼痛控制的共识声明仍未达成,这些相关性可能对临床有所帮助。可以通过术前人口统计学数据、筛查问卷或其他工具来识别剖宫产术后发生严重急性疼痛的高风险患者。还需要进一步的研究来确定更多的变量或筛查工具,以进行更准确的预测,并研究个性化镇痛方案是否能改善镇痛效果。
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来源期刊
Current Pain and Headache Reports
Current Pain and Headache Reports CLINICAL NEUROLOGY-
CiteScore
6.10
自引率
2.70%
发文量
91
审稿时长
6-12 weeks
期刊介绍: This journal aims to review the most important, recently published clinical findings regarding the diagnosis, treatment, and management of pain and headache. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of pain and headache. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as anesthetic techniques in pain management, cluster headache, neuropathic pain, and migraine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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