Preoperative scar hyperalgesia is associated with post‐operative pain in women undergoing a repeat Caesarean delivery

Ortner, Clemens; Granot, Michal; Richebé, Philippe; Cardoso, Marcio Vivan; Bollag, Laurent; Landau, Ruth

doi:10.1002/j.1532-2149.2012.00171.x

Cited by 55 publications

(46 citation statements)

References 55 publications

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“…Our study has demonstrated that early multimodal PCOA is as effective (non‐inferior) as standard multimodal parenteral analgesia for post‐caesarean section pain during the critical first 48 h. Despite randomisation, there were differences in the numbers of twin pregnancies and previous caesarean section between the groups; if anything, this would have been expected to make pain worse in the PCOA group .…”

Section: Discussionmentioning

confidence: 72%

Patient-controlled oral analgesia versus nurse-controlled parenteral analgesia after caesarean section: a randomised controlled trial

et al. 2016

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SummaryWe assessed the effectiveness of early patient-controlled oral analgesia compared with parenteral analgesia in a randomised controlled non-inferiority trial of women undergoing elective caesarean section under regional anaesthesia. Seventy-seven women received multimodal paracetamol, ketoprofen and morphine analgesia. The woman having patient-controlled oral analgesia were administered four pillboxes on the postnatal ward containing tablets and instructions for self-medication, the first at 7 h after the spinal injection and then three more at 12-hourly intervals. Pain at rest and on movement was evaluated using an 11-point verbal rating scale at 2 h and then at 6-hourly intervals for 48 h. The pre-defined non-inferiority limit for the difference in mean pain scores (patient-controlled oral analgesia minus parenteral) was one. The one-sided 95% CI of the difference in mean pain scores was significantly lower than one at all time-points at rest and on movement, demonstrating non-inferiority of patient-controlled oral analgesia. More women used morphine in the patient-controlled oral analgesia group (22 (58%)) than in the parenteral group (9 (23%); p = 0.002). The median (IQR [range]) number of morphine doses in the patient-controlled oral analgesia group was 2 (1-3 [1-7]) compared with 1 (1-1 [1-2]); p = 0.006) in the parenteral group. Minor drug errors or omissions were identified in five (13%) women receiving patient-controlled oral analgesia. Pruritus was more frequent in the patient-controlled oral analgesia group (14 (37%) vs 6 (15%) respectively; p = 0.03), but no differences were noted for other adverse events and maternal satisfaction. After elective caesarean section, early patientcontrolled oral analgesia is non-inferior to standard parenteral analgesia for pain management, and can be one of the steps of an enhanced recovery process.

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Section: Discussionmentioning

confidence: 72%

Patient-controlled oral analgesia versus nurse-controlled parenteral analgesia after caesarean section: a randomised controlled trial

et al. 2016

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“…These patients represent a significant proportion of the workload in many chronic pain clinics and are more difficult to manage. Various factors are associated with the incidence of PPSP (Niraj and Rowbotham, 2011), and the severity of preoperative pain status correlates with the development of chronic post-surgical pain (Ortner et al, 2013;Tsirline et al, 2013). This state may be partially mediated by the induction and amplification of central neural plasticity from central sensitization (Latremoliere and Woolf, 2009).…”

Section: Introductionmentioning

confidence: 99%

Spinal protein kinase Mζ contributes to the maintenance of peripheral inflammation‐primed persistent nociceptive sensitization after plantar incision

Zhen

Liu

et al. 2014

European Journal of Pain

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“…One such study found that postoperative pain scores after C-section were higher in women with preoperative scar hyperalgesia than in those without hyperalgesia, although no significant difference was found between the groups in terms of postoperative analgesic consumption [27]. Another study used a psychological test (State-Trait Anxiety Inventory – STAI) to measure preoperative state and trait anxiety of the patients and demonstrated that preoperative STAI scores correlated with postoperative analgesic consumption [28].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Serum Leptin Level Is Associated with Preoperative Pain Threshold and Postoperative Analgesic Consumption in Patients Undergoing Cesarean Section

et al. 2019

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Objective: This study aimed to investigate the preoperative level of serum leptin in cesarean section (C-section) patients with and without acute labor pain and its association with postoperative analgesic consumption and preoperative pain threshold. Materials and Methods: Preoperative leptin levels, preoperative pain threshold, postoperative analgesic consumption in the first 24 h, and postoperative pain severity (visual analog scale (VAS) scores at 1, 2, 4, 6, 12, and 24 h postoperatively) in C-section patients with labor pain (emergency C-section; n = 21) and without labor pain (elective C-section; n = 25) were compared. Results: There were no signiﬁcant differences between the groups regarding the demographic characteristics. Leptin levels, postoperative VAS scores, and analgesic consumption were significantly higher in the group with labor pain, while the preoperative pain threshold was lower. Serum leptin levels correlated negatively with pain threshold and positively with postoperative analgesic consumption. Multiple linear regression analyses in our study revealed that the preoperative leptin levels and having an emergency C-section independently affected the postoperative analgesic consumption and preoperative pain threshold, whereas their combined effects on these parameters were statistically not significant. Conclusion: Preoperative levels of serum leptin were higher in C-section patients with labor pain than in those without labor pain, and increased serum leptin levels were associated with decreased preoperative pain threshold and increased postoperative analgesic consumption in our study population. Postoperative analgesic requirements may vary among patients, and their requirements might be predicted using preoperative indicators. Serum levels of leptin might be one such indicator and this warrants further studies with larger sample sizes.

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Preoperative scar hyperalgesia is associated with post‐operative pain in women undergoing a repeat Caesarean delivery

Cited by 55 publications

References 55 publications

Patient-controlled oral analgesia versus nurse-controlled parenteral analgesia after caesarean section: a randomised controlled trial

Patient-controlled oral analgesia versus nurse-controlled parenteral analgesia after caesarean section: a randomised controlled trial

Spinal protein kinase Mζ contributes to the maintenance of peripheral inflammation‐primed persistent nociceptive sensitization after plantar incision

Preoperative Serum Leptin Level Is Associated with Preoperative Pain Threshold and Postoperative Analgesic Consumption in Patients Undergoing Cesarean Section

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