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

doi:10.3390/jcm12226999

Open AccessArticle

Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients

by

Norah L. A. Emrich

^1,*

,

Laura Tascón Padrón

¹,

Marcus Komann

²

,

Christin Arnold

²,

Johannes Dreiling

²

,

Winfried Meißner

²

,

Brigitte Strizek

¹

,

Ulrich Gembruch

¹

and

Jorge Jiménez Cruz

¹

Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany

²

Department for Anesthesiology and Intensive Care Medicine, University Hospital of Jena, Am Klinikum 1, 07740 Jena, Germany

^*

Author to whom correspondence should be addressed.

J. Clin. Med. 2023, 12(22), 6999; https://doi.org/10.3390/jcm12226999

Submission received: 25 September 2023 / Revised: 17 October 2023 / Accepted: 3 November 2023 / Published: 9 November 2023

(This article belongs to the Section General Surgery)

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Abstract

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.

Keywords: postoperative pain; cesarean section; analgesic treatment; non-pharmacological therapy; primary cesarean section; urgent cesarean section; opioids

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MDPI and ACS Style

Emrich, N.L.A.; Tascón Padrón, L.; Komann, M.; Arnold, C.; Dreiling, J.; Meißner, W.; Strizek, B.; Gembruch, U.; Jiménez Cruz, J. Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients. J. Clin. Med. 2023, 12, 6999. https://doi.org/10.3390/jcm12226999

AMA Style

Emrich NLA, Tascón Padrón L, Komann M, Arnold C, Dreiling J, Meißner W, Strizek B, Gembruch U, Jiménez Cruz J. Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients. Journal of Clinical Medicine. 2023; 12(22):6999. https://doi.org/10.3390/jcm12226999

Chicago/Turabian Style

Emrich, Norah L. A., Laura Tascón Padrón, Marcus Komann, Christin Arnold, Johannes Dreiling, Winfried Meißner, Brigitte Strizek, Ulrich Gembruch, and Jorge Jiménez Cruz. 2023. "Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients" Journal of Clinical Medicine 12, no. 22: 6999. https://doi.org/10.3390/jcm12226999

APA Style

Emrich, N. L. A., Tascón Padrón, L., Komann, M., Arnold, C., Dreiling, J., Meißner, W., Strizek, B., Gembruch, U., & Jiménez Cruz, J. (2023). Risk Factors for Severe Pain and Impairment of Daily Life Activities after Cesarean Section—A Prospective Multi-Center Study of 11,932 Patients. Journal of Clinical Medicine, 12(22), 6999. https://doi.org/10.3390/jcm12226999

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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

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