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Background <p>The cesarean section was associated with moderate to severe postoperative pain. Uncertain differences exist between parturient who undergo a primary cesarean section and a repeat cesarean section in terms of post-operative pain.</p> Objective <p>To compare the degree of postoperative pain in patients who had primary and repeat cesarean sections.</p> Method <p>An institutional-based prospective cohort study was conducted on 336 patients who fulfilled eligibility criteria and underwent caesarian section under spinal anesthesia. Study participants were selected by a systematic random sampling technique. An independent sample t test and a Mann–Whitney U test were used to compare symmetric and asymmetric data, respectively. Time to first analgesic request was analyzed using log rank Kaplan–Meier survival curves and cox-regression for covariates. Comparisons of categorical variables between groups were done using the chi-square test. The significance was determined at a <i>P</i> value of &lt; 0.05.</p> Results <p>There was a high Risk of moderate to severe postoperative pain in repeated caesarean section compared to primary caesarean section in both incisional pain (RR, 1.364[95% CI, 1.12–1.66], <i>p</i> = 0.002) and visceral pain (RR, 1.66[95% CI, 1.40–1.66], <i>p</i> = 0.001). In comparison to the primiparas, parturient with repeated cesarean sections had highest post-operative pain severity in NRS with median NRS of 5(IQR, 3–5) at the 4th hour (<i>p</i> &lt; 0.001) for the incisional pain and 6(IQR, 5–7) at the 8th hour for visceral pain, respectively, for the repeated group. The primiparas group had a longer median time to first rescue analgesic administration (median [minute], 875.7[95% CI, 750.3–1001]; <i>P</i> &lt; 0.001)) than the repeated group (median [minute], 534.8 [95% CI, 426.8–642.8]; <i>P</i> &lt; 0.001.</p> Conclusions <p>Compared to primary CS, repeated cesarean had a high incidence of moderate to severe postoperative pain, both visceral and incisional; within 48-h. In future endeavors of crafting postoperative analgesic plans, it is imperative to take into account individual variations and distinctions.</p>

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Comparison of postoperative pain severity between primary and repeated cesarean section: a prospective cohort study

  • 期刊论文

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  • 发表日期：

    2025年2月22日

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  • Zemedkun Getahun,
  • Mebratu Kebede,
  • Mebratu Tilla,
  • Gedion Asnak,
  • Margherita iuzzolino,
  • Alemu Urmale,
  • Hailemariam Getachew,
  • Abebayehu Zemedkun,
  • Tsegaye Demeke,
  • Milion Abdi,
  • Ashagire Sintayehu,
  • Getahun Dendir

摘要

Background

The cesarean section was associated with moderate to severe postoperative pain. Uncertain differences exist between parturient who undergo a primary cesarean section and a repeat cesarean section in terms of post-operative pain.

Objective

To compare the degree of postoperative pain in patients who had primary and repeat cesarean sections.

Method

An institutional-based prospective cohort study was conducted on 336 patients who fulfilled eligibility criteria and underwent caesarian section under spinal anesthesia. Study participants were selected by a systematic random sampling technique. An independent sample t test and a Mann–Whitney U test were used to compare symmetric and asymmetric data, respectively. Time to first analgesic request was analyzed using log rank Kaplan–Meier survival curves and cox-regression for covariates. Comparisons of categorical variables between groups were done using the chi-square test. The significance was determined at a P value of < 0.05.

Results

There was a high Risk of moderate to severe postoperative pain in repeated caesarean section compared to primary caesarean section in both incisional pain (RR, 1.364[95% CI, 1.12–1.66], p = 0.002) and visceral pain (RR, 1.66[95% CI, 1.40–1.66], p = 0.001). In comparison to the primiparas, parturient with repeated cesarean sections had highest post-operative pain severity in NRS with median NRS of 5(IQR, 3–5) at the 4th hour (p < 0.001) for the incisional pain and 6(IQR, 5–7) at the 8th hour for visceral pain, respectively, for the repeated group. The primiparas group had a longer median time to first rescue analgesic administration (median [minute], 875.7[95% CI, 750.3–1001]; P < 0.001)) than the repeated group (median [minute], 534.8 [95% CI, 426.8–642.8]; P < 0.001.

Conclusions

Compared to primary CS, repeated cesarean had a high incidence of moderate to severe postoperative pain, both visceral and incisional; within 48-h. In future endeavors of crafting postoperative analgesic plans, it is imperative to take into account individual variations and distinctions.