Assessing the Experience and Management of Acute Post-Operative Pain from Caesarean Delivery: A Multi-Centre Cohort Study

<b>Background:</b> Caesarean section is considered one of the surgeries with the highest prevalence of postoperative pain, yet this is often underestimated and undertreated. This study was aimed at evaluating the prevalence and severity of postoperative pain, assessing which analgesic strategy is the most effective and identifying those risk factors associated with poorer analgesic results. <b>Methods:</b> A multi-centre observational study was conducted on 514 women undergoing elective caesarean section. The primary endpoints included postoperative pain severity at rest and with movement at 6 and 24 h. <b>Results:</b> The combination of intrathecal morphine and fentanyl with acetaminophen and Non Steroid Anti-inflammatory Drugs (NSAIDs) was associated with better pain control than any of the following treatments: intrathecal fentanyl with systemic acetaminophen and NSAIDs (2.49 ± 2.04 vs. 3.91 ± 2.75, ES = -0.610, <i>p</i> = 0.01), elastomeric pump at 6 h at rest (2.49 ± 2.04 vs. 4.10 ± 2.86, ES -0.733, <i>p</i> = 0.04) and with movement (4.44 ± 2.41 vs. 6.14 ± 3.08, ES -0.671, <i>p</i> = 0.01) or epidural analgesia (4.44 ± 2.41 vs. 5.65 ± 2.57, ES -0.496, <i>p</i> = 0.02). No risk factors predicting poorer postoperative analgesia were found. <b>Conclusions:</b> The prevalence of postoperative pain control after elective caesarean section is high. The best analgesic postoperative regimen includes intrathecal morphine together with fentanyl and systemic analgesics. No risk factors associated with poorer outcomes were found.

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Journal
Journal of Clinical Medicine
Published
2025-06-30
DOI
https://doi.org/10.3390/jcm14134638
Citations
1
Primary Topic
Anesthesia and Pain Management
Type
article
Field-Weighted Citation Impact
2.01

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article

Assessing the Experience and Management of Acute Post-Operative Pain from Caesarean Delivery: A Multi-Centre Cohort Study

Mireia Raynard, Carolina García Bartoló, David Martínez‐Rodríguez, Brian Draper et al.
1 citations
Journal of Clinical Medicine
Anesthesia and Pain Management
2.01
article

Assessing the Experience and Management of Acute Post-Operative Pain from Caesarean Delivery: A Multi-Centre Cohort Study

Mireia Raynard, Carolina García Bartoló, David Martínez‐Rodríguez, Brian Draper, A. Batalla, Martha Cristina Melo Cruz, Beatriz Tena, Laura Subirana Giménez, Gisela Roca Amatria, Maria Martinez García, Carles Espinós Ramírez, Anna Peig Font, Paula Gil Esteller, Alèxia Nebot Galindo, Jean Louis Clave, Gerard Mestres, V. Sánchez-Migallón, Pere Castellví, Mireia Armengol Gay, Paula Masgoret, Marta Homs, Ana María Plaza Moral, Antoni Gelabert, Irlanda Campos Pérez, Paz Ribas, Lluís Toll Salillas, Natàlia Montero Gaig, David Valencia Royo, Núria Lara Pacheco Comino, Claudia Teixell, Adrián Fernández Castiñeira, Beatriz Fort Pelai, Carolina Mestre Iniesta, Sandra Gasca Pera, Verónica Vargas Raidi, Cristina Rodríguez Cosmen
article en
1 citations

Abstract

<b>Background:</b> Caesarean section is considered one of the surgeries with the highest prevalence of postoperative pain, yet this is often underestimated and undertreated. This study was aimed at evaluating the prevalence and severity of postoperative pain, assessing which analgesic strategy is the most effective and identifying those risk factors associated with poorer analgesic results. <b>Methods:</b> A multi-centre observational study was conducted on 514 women undergoing elective caesarean section. The primary endpoints included postoperative pain severity at rest and with movement at 6 and 24 h. <b>Results:</b> The combination of intrathecal morphine and fentanyl with acetaminophen and Non Steroid Anti-inflammatory Drugs (NSAIDs) was associated with better pain control than any of the following treatments: intrathecal fentanyl with systemic acetaminophen and NSAIDs (2.49 ± 2.04 vs. 3.91 ± 2.75, ES = -0.610, <i>p</i> = 0.01), elastomeric pump at 6 h at rest (2.49 ± 2.04 vs. 4.10 ± 2.86, ES -0.733, <i>p</i> = 0.04) and with movement (4.44 ± 2.41 vs. 6.14 ± 3.08, ES -0.671, <i>p</i> = 0.01) or epidural analgesia (4.44 ± 2.41 vs. 5.65 ± 2.57, ES -0.496, <i>p</i> = 0.02). No risk factors predicting poorer postoperative analgesia were found. <b>Conclusions:</b> The prevalence of postoperative pain control after elective caesarean section is high. The best analgesic postoperative regimen includes intrathecal morphine together with fentanyl and systemic analgesics. No risk factors associated with poorer outcomes were found.

Journal of Clinical MedicineVol. 14(13)
Hospital Sant Joan de Déu Barcelona (ES), Hospital de Sant Pau (ES), Universitat Internacional de Catalunya (ES), Hospital Universitario Dexeus (ES), Consorci Sanitari de Terrassa (ES), Maresme Health Consortium (ES), Hospital Clínic de Barcelona (ES), Corporació Sanitària Parc Taulí (ES), Vall d'Hebron Hospital Universitari (ES), Mútua Terrassa (ES), Hospital Del Mar (ES), Hospital Universitari Sagrat Cor (ES), Hospital Universitari Germans Trias i Pujol (ES), Consorci Sanitari Garraf (ES), Universitat Politècnica de València (ES)
Generalitat de Catalunya
No poverty
Openalex Percentile: Top 14%
Anesthesia and Pain Management
2.01
DOIOpen Access PDFOpenAlex
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