Postoperative Pain After Cesarean Section at University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia, 2019; A Cross-Sectional Follow-up Study

Abstract

Background: Cesarean section is one of the most common obstetric procedures worldwide. Following this, parturients experience moderate to severe pain in the acute postoperative period. Therefore, in resource-limited settings, for full utilization of basic analgesic modalities and to take appropriates interventions, it is vital to know about the magnitude of the problem and its factors.Objective: To assess the prevalence and factors associated with postoperative pain after cesarean section at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia, 2019.Methods: A hospital-based prospective follow-up study was conducted among parturients who undergo cesarean section in the University of Gondar Comprehensive Specialized Hospital, from mid-February to April 20, 2019, after approval of the ethical review committee. Consecutively, a total of 290 parturients were included with a response rate of 97%. To measure pain severity numerical rating scale was used. Data was entered into Epi-data version 4.2 and analyzed by SPSS version 20 (IBM Corporate). The association between independent factors and the outcome variable was determined at 95% CI with the chi-squared test, bivariate, and multivariate logistic regression. Hosmer-Lemeshow test was used to assess the goodness of fit. Variables with a p-value of < 0.05 were considered significant.Results: In this study, the incidence of moderate to severe post-operative pain after cesarean section was 85.5% (95% CI: 81.4%, 89.0%) within the first 24 postoperative hours. On the multi-variable analysis, preoperative anxiety (AOR: 2.3, 95% CI: 1.1, 4.9), history of previous cesarean section (AOR: 2.3, 95% CI: 1.1, 5.0), Pfannenstiel incision (AOR: 3.2, 95% CI: 1.3, 8.0) and absence of regional analgesia (AOR: 3.7, 95% CI: 1.7, 7.9) were significantly associated with moderate to severe postoperative pain after cesarean section.Conclusions: In this study, a large proportion of parturients had experienced moderate to severe post-cesarean pain in the first 24 postoperative hours. Preoperative anxiety, history of previous cesarean section, Pfannenstiel incision, and parturients with no regional analgesia were significantly associated with post-cesarean pain. Pain severity needs to be assessed and documented by using pain-rating scales and there should be an interdisciplinary approach to provide adequate pain management in our hospital.