INCIDENCE AND PREDICTORS FOR MODERATE TO SEVERE POSTOPERATIVE PAIN AFTER CESAREAN SECTION UNDERGOING SPINAL ANESTHESIA AT DILLA UNIVERSITY REFERRAL HOSPITAL AND HAWASSA UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL 2022: MULTICENTER PROSPECTIVE SINGL

<strong> Abstract</strong> Background: Inadequate treatment of postoperative pain is resulting in a delay in patients’ recovery, affects the interaction between mother and baby, longer hospital stays, and increases the incidence of chronic pain. In limited resource areas, postoperative pain management is challenging because of the inadequate administration of pain relief drugs and the high patient-to nurse ratio that limits the assessment of pain. Objective: To assess the incidence and predictors of moderate to severe postoperative pain after cesarean section undergoing spinal anesthesia at Dilla University Referral Hospital and Hawassa University Comprehensive Specialized Hospital from February 1 to June 10, 2022. Methods: A prospective single-armed cohort study was conducted at Dilla University Referral Hospital and Hawassa University Comprehensive Specialized Hospital from February 1 to June 10, 2022. A total 205 parturients who underwent cesarean sections under spinal anesthesia were included during the study period. The numeric rating scale was used to assess pain severity. Binary logistic regression was used to identify independent risk factors for postoperative pain. Variables with a p-value less than 0.25 on bivariate logistic analysis were taken to multivariate logistic regression analysis. Results: In our study, the incidence of moderate to severe post-operative pain after the cesarean section was 71.2% within the first 24 postoperative hours. On the multi-variable analysis, preoperative anxiety (AOR: 2.849, 95% CI: 1.276, 6.359), history of previous cesarean section (AOR: 3.571, 95% CI: 1.536, 8.300) and transverse incision (AOR: 6.965, 95% CI: 2.469, 19.652) were predictors for moderate to severe postoperative pain after cesarean section. Abdominal field blocks decreased the incidence of postoperative pain (AOR: 0.035, 95% CI: 0.009, 0.139). Conclusion: In this study, a large number of parturients experienced moderate to severe post cesarean pain in the first 24 postoperative hours. Preoperative anxiety, history of previous cesarean section, and transverse incision were predictors for moderate to severe post-cesarean pain. Fields blocks were reduced severity of post-cesarean pain.