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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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Autores principales: Emrich, Norah L. A., Tascón Padrón, Laura, Komann, Marcus, Arnold, Christin, Dreiling, Johannes, Meißner, Winfried, Strizek, Brigitte, Gembruch, Ulrich, Jiménez Cruz, Jorge
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10672043/
https://www.ncbi.nlm.nih.gov/pubmed/38002614
http://dx.doi.org/10.3390/jcm12226999
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author Emrich, Norah L. A.
Tascón Padrón, Laura
Komann, Marcus
Arnold, Christin
Dreiling, Johannes
Meißner, Winfried
Strizek, Brigitte
Gembruch, Ulrich
Jiménez Cruz, Jorge
author_facet Emrich, Norah L. A.
Tascón Padrón, Laura
Komann, Marcus
Arnold, Christin
Dreiling, Johannes
Meißner, Winfried
Strizek, Brigitte
Gembruch, Ulrich
Jiménez Cruz, Jorge
author_sort Emrich, Norah L. A.
collection PubMed
description 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.
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spelling pubmed-106720432023-11-09 Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients Emrich, Norah L. A. Tascón Padrón, Laura Komann, Marcus Arnold, Christin Dreiling, Johannes Meißner, Winfried Strizek, Brigitte Gembruch, Ulrich Jiménez Cruz, Jorge J Clin Med Article 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. MDPI 2023-11-09 /pmc/articles/PMC10672043/ /pubmed/38002614 http://dx.doi.org/10.3390/jcm12226999 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Emrich, Norah L. A.
Tascón Padrón, Laura
Komann, Marcus
Arnold, Christin
Dreiling, Johannes
Meißner, Winfried
Strizek, Brigitte
Gembruch, Ulrich
Jiménez Cruz, Jorge
Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients
title Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients
title_full Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients
title_fullStr Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients
title_full_unstemmed Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients
title_short Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients
title_sort risk factors for severe pain and impairment of daily life activities after cesarean section—a prospective multi-center study of 11,932 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10672043/
https://www.ncbi.nlm.nih.gov/pubmed/38002614
http://dx.doi.org/10.3390/jcm12226999
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