Prevalence and risk factors for chronic pain following cesarean section: a prospective study

Abstract

BackgroundChronic post-surgical pain (CPSP) remains a major clinical problem which may be associated with impaired activities of daily life and decreased health-related quality of life. Although cesarean section is one of the most commonly performed operations, chronic pain after cesarean delivery has not been well-studied. The purpose of this prospective study was to assess the incidence and risk factors of chronic pain at 3, 6 and 12 months after cesarean delivery.MethodsWe prospectively investigated preoperative demographic and psychological factors, intraoperative clinical factors, and acute postoperative pain in a cohort of 527 women undergoing cesarean section. The women were interviewed and completed pain questionnaires after 3, 6 and 12 months. Questions were about pain intensity, frequency, and location, as well as medical treatment and impact on daily living.ResultsThe incidence of CPSP at 3, 6 and 12 months after cesarean section was 18.3 %, 11.3 % and 6.8 %, respectively. Most of the women with CPSP experienced mild pain at rest. The incidence of moderate and severe pain on movement was high at 3 month, and then has a significant decrease at 6 and 12 months. CPSP had a negative influence on the activities of daily living. Independent predictors of CPSP at 3 months included higher average pain intensity on movement within 24 h postoperatively, preoperative depression, and longer duration of surgery. At 6 months, more severe pain during movement within 24 h of surgery and preoperative depression were predictive of pain persistence. And 12 months after surgery, only higher average pain score on movement within 24 h following cesarean section was found to be significant associated with CPSP. The three models all showed moderate discrimination and good calibration for the prediction of CPSP at 3, 6 and 12 months postoperatively.ConclusionsCPSP was not rare in women undergoing cesarean section. Patients with more intense of acute postoperative pain on movement, preoperative depression, and longer surgical time had greater risk for CPSP following surgery.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-016-0270-6) contains supplementary material, which is available to authorized users.

Transversus abdominis plane block and quadratus lumborum block did not reduce the incidence or severity of chronic postsurgical pain following cesarean section: a prospective, observational study

“…In most studies, the incidence of CPSP after cesarean section rarely exceeds 18% at the sixth month [4][5][6][7][8][9]. In a study by Jin et al [17], only 18.3% and 11.3% of patients experienced CPSP three and six months after cesarean section, respectively. The authors of this paper used the Brief Pain Inventory for CPSP evaluation.…”

Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1)

“…months to years to end of life) pain. The intensity and duration of pain in recovery is an important indicator of the likelihood of chronic pain development in humans (Althaus et al, 2018;Boerboom et al, 2018;de Brito, Omanis, Ashmawi, & Torres, 2012;Jin et al, 2016;Rashiq & Dick, 2014;Voscopoulos & Lema, 2010). The fact that human patients with local anaesthetic drugs included in the analgesic protocols were less likely to develop both postoperative and chronic pain is a very compelling reason to utilize local/regional blockade (Boerboom et al, 2018;de Brito et al, 2012;Rashiq & Dick, 2014).…”

Chronic Pain Incidence After Elective and Emergency Caesarean Sections

“…In the present study, we found the frequency of chronic pain in the minimum three-month period after the C/S to be 16.4%. Jin et al (11) demonstrated that chronic pain was observed as 18.3%, 11.3% and 6.8% in three, six and 12 months after caesarean section. In another study conducted by Nikolajsen et al (12), which included 220 C/S patients, reported the frequency of chronic pain after C/S to be 18.6% in the first three months, which dropped down to 12.3% ten months later.…”