DOI: https://doi.org/10.14710/jai.v0i0.57730

Relationship Between Pain Severity in Post-Caesarean Section and Its Preoperative Factors

1Anesthesiology, Intensive Care, and Pain Management Medical Staff, dr. Soehadi Prijonegoro Public Hospital, Sragen, Indonesia

2Medical Education Study Program, Faculty of Medicine, Universitas Islam Indonesia, Yogyakarta, Indonesia

Received: 27 Aug 2023; Revised: 1 Nov 2023; Accepted: 1 Nov 2023; Available online: 30 Nov 2023; Published: 1 Nov 2023.

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Abstract

Background: According to the World Health Organization (WHO), the global prevalence of cesarean section (C-section) reaches 21% of all deliveries and is expected to increase to 29% by 2030. This major surgery is associated with moderate to severe postoperative pain. Previous studies have shown that factors such as emergency cases, preoperative anxiety, previous C-sections, length of surgery, type of anesthesia, and pain medication are all important factors contributing to post-C-section pain.

Objective: To identify preoperative factors that affect post-cesarean pain, including age, gravida, previous C-section, anthropometry, preeclampsia (PE), fetal malposition, premature rupture of the membranes (PROM), human immunodeficiency virus (HIV), malnutrition, preterm labor, hepatitis B, anemia, and emergency procedure.

Methods: A cross-sectional study was conducted at dr. Soehadi Prijonegoro Hospital, Sragen, Indonesia. The inclusion criteria are: (1) willing to participate in this study, (2) age more than 18 years old, (3) cooperative and communicative, and (4) not in disability condition. We analyzed the data using Wilcoxon and Spearman's tests with Statistical Package for the Social Sciences (SPSS) version 25. This research has conducted ethical approval by the Ethics Committee.

Results: From 30 subjects, the age spread between 22 to 44 years, with 20% being older than 35 years pregnant women. Most patients experienced moderate (Numeric Rating Scale [NRS] 4 to 6: 60%) and severe pain (NRS 7 to 10: 30%) 12 hours after surgery. While at 24 hours, the majority experienced mild (NRS 1 to 3: 36.7%) to moderate pain (NRS 4 to 6: 46.7%). Our analysis did not identify any preoperative factors significantly related to pain levels after 12- and 24-hours following C-section (p > 0.05).

Conclusion: There is no relationship between preoperative factors and postoperative pain. Nonetheless, pain management should be tailored to each patient’s clinical condition.

 

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Keywords: cesarean section; numeric rating scale; postoperative pain; preoperative factors; surgery

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Language : EN
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  1. Nurhaida. Nurse’s Knowledge in Accomplishing Actions and Following Procedures for Post Sectio Caesarea Wound Care. Science Midwifery journal. 2022;10(3):2260–3. DOI: https://doi.org/10.35335/midwifery.v10i3.645
  2. Wyatt S, Silitonga PII, Febriani E, Long Q. Socioeconomic, geographic and health system factors associated with rising C-section rate in Indonesia: A cross-sectional study using the Indonesian demographic and health surveys from 1998 to 2017. Vol. 11, BMJ Open. BMJ Publishing Group; 2021. DOI: https://doi.org/10.1136/bmjopen-2020-045592
  3. Keenan L, Noble E. Caesarean section rates continue to rise, amid growing inequalities in access. WHO. 2021. p. 1
  4. Ashar H, Kusrini I. Determinant of the Increased Sectio Caesarea Labor Rates of Indonesia in 2017. 2020;22(Ishr 2019):268–72. DOI: https://doi.org/10.2991/ahsr.k.200215.051
  5. Sobhy S, Arroyo-Manzano D, Murugesu N, Karthikeyan G, Kumar V, Kaur I, et al. Maternal and perinatal mortality and complications associated with caesarean section in low-income and middle-income countries: a systematic review and meta-analysis. The Lancet. 2019 May 11;393(10184):1973–82. DOI: https://doi.org/10.1016/s0140-6736(18)32386-9
  6. Benli AR, Cetin Benli N, Usta AT, Atakul T, Koroglu M. Effect of Maternal Age on Pregnancy Outcome and Cesarean Delivery Rate. J Clin Med Res. 2015;7(2):97–102. DOI: https://doi.org/10.14740/jocmr1904w
  7. Weibel S, Neubert K, Jelting Y, Meissner W, Wöckel A, Roewer N, et al. Incidence and severity of chronic pain after caesarean section: A systematic review with meta-analysis. Eur J Anaesthesiol. 2016;33(11):853–65. DOI: https://doi.org/10.1097/eja.0000000000000535
  8. Yimer H, Woldie H. Incidence and Associated Factors of Chronic Pain After Caesarean Section: A Systematic Review. Journal of Obstetrics and Gynaecology Canada. 2019;41(6):840–54. DOI: https://doi.org/10.1016/j.jogc.2018.04.006
  9. Gumelar W, Sumartono C. The Effectiveness of Intraoperative Ketamine and Fentanyl as Preemptive Analgesia Assessed with qNOX Score. Jurnal Anestesiologi Indonesia. 2021;13(2). DOI: https://doi.org/10.14710/jai.v13i2.31900
  10. Azanu WK, Joseph O, Larsen-Reindorf RE, Agbeno EK, Dassah E, Amanfo AO, et al. Assessment and determinants of acute postcaesarean section pain in a tertiary facility in Ghana. PLoS One. 2022;(17):1–15. DOI: https://doi.org/10.1371/journal.pone.0268947
  11. Haeruddin H, Ahmad MR. Pengaruh Pemberian Parecoxib Terhadap Kadar Il-6 dan Intensitas Nyeri Pascabedah Laparotomi Ginekologi. Jurnal Anestesiologi Indonesia. 2013;V(2). DOI: https://doi.org/10.14710/jai.v5i2.6408
  12. Maged AM, Deeb WS, Elbaradie S, Elzayat AR, Metwally AA, Hamed M, et al. Comparison of local and intra venous dexamethasone on post operative pain and recovery after caeseream section. A randomized controlled trial. Taiwan J Obstet Gynecol. 2018;57(3):346–50. DOI: https://doi.org/10.1016/j.tjog.2018.04.004
  13. Arslantas R, Umuroglu T. Comparing the effects of general and spinal anesthesia on the postoperative pain intensity in patients undergoing emergent or elective cesarean section. Marmara Medical Journal. 2019;32(2):62–7. DOI: https://doi.org/10.5472/marumj.570905
  14. De Carvalho Borges N, Pereira LV, De Moura LA, Silva TC, Pedroso CF. Predictors for moderate to severe acute postoperative pain after cesarean section. Pain Res Manag. 2016;2016. DOI: https://doi.org/10.1155/2016/5783817
  15. Bimrew D, Misganaw A, Samuel H, Daniel Desta T, Bayable SD. Incidence and associated factors of acute postoperative pain within the first 24 h in women undergoing cesarean delivery at a resource-limited setting in Addis Ababa, Ethiopia: A prospective observational study. SAGE Open Med. 2022;10. DOI: https://doi.org/10.1177/20503121221133190
  16. Metasari D, Berlian S. Factors That Affect Decrease of Post Operation Sectio Caesarea in RS Raflessia Bengkulu. JNPH. 2018;6(1). DOI: https://doi.org/10.37676/jnph.v6i1.488
  17. Harini R, Cahyo Y, Kambocie S, Aini N. Relation between Knowledge and Pain Intensity with Early Mobilization in Post Sectio Caesarea Mothers. The Proceeding: International. 2022
  18. Gupta A, Kaur K, Sharma S, Goyal S, Arora S, Murthy RSR. Clinical aspects of acute post-operative pain management & its assessment. J Adv Pharm Technol Res. 2010;1(2):97–108
  19. Small C, Laycock H. Acute postoperative pain management. British Journal of Surgery. 2020;107(2):e70–80. DOI: https://doi.org/10.1002/bjs.11477
  20. Yang G, Bao X, Peng J, Li J, Yan G, Jing S, et al. Repeated cesarean delivery predicted a higher risk of inadequate analgesia than primary cesarean delivery: A retrospective study with propensity score match analysis. J Pain Res. 2020;13:555–63. DOI: https://doi.org/10.2147/jpr.s229566
  21. Duan G, Yang G, Peng J, Duan Z, Li J, Tang X, et al. Comparison of postoperative pain between patients who underwent primary and repeated cesarean section: A prospective cohort study. BMC Anesthesiol. 2019;19(1). DOI: https://doi.org/10.1186/s12871-019-0865-9
  22. Liu T, Raju A, Boesel T, Cyna AM, Tan SGM. Chronic pain after caesarean delivery: an Australian cohort. Anaesth Intensive Care. 2013;(41):496–500. DOI: https://doi.org/10.1177/0310057x1304100410
  23. Noura SH, Shadia HM, Amal AO, Eman MA. Assessing the Quality of Life among Women Undergoing Elective Cesarean Section versus Emergency Cesarean Section. Egyptian Journal of Health Care. 2018;9(1):71–82. DOI: https://doi.org/10.21608/ejhc.2018.11907
  24. Stopher L, Jansen S. Systematic review of the impact and treatment of malnutrition in patients with chronic vascular wounds. Wound Practice and Research. 2017;25(2)
  25. Action C. The importance of nutrition in wound healing. Wounds UK. 2013;9(3):61–4
  26. Husna C, Fitri A, Munira D. The Effectiveness of High Protein Nutrient to The Post Sectio Caesarea Healing Process. Jurnal Medika Veterinaria. 2019(2):192–9. DOI: https://doi.org/10.21157/j.med.vet..v13i2.14090
  27. Ayensu J, Annan R, Lutterodt H, Edusei A, Peng LS. Prevalence of anaemia and low intake of dietary nutrients in pregnant women living in rural and urban areas in the Ashanti region of Ghana. PLoS One. 2020;15(1). DOI: https://doi.org/10.1371/journal.pone.0226026
  28. Aji S, Nawangwulan K, Irianni R, Ruben SD, Achirman, Izza NC, et al. Nutritional status and anemia on wound healing process in post cesarean section patients. International Journal of Nursing and Midwifery Research. 2022;1(1):58–61
  29. Gouin JP, Kiecolt-Glaser JK. The Impact of Psychological Stress on Wound Healing: Methods and Mechanisms. Vol. 31, Immunology and Allergy Clinics of North America. 2011. p. 81–93. DOI: https://doi.org/10.1016/j.iac.2010.09.010

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