Assessing the Experience and Management of Acute Post-Operative Pain from Caesarean Delivery : A Multi-Centre Cohort Study
Ramírez, Carles Espinós (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Amatria, Gisela Roca (Hospital del Sagrat Cor (Barcelona, Catalunya))
Castellví Obiols, Pere (Universitat Internacional de Catalunya (UIC Barcelona))
Martínez-Rodríguez, David (Instituto Universitario de Matemática Multidisciplinar. Universitat Politècnica de València)
Masgoret, Paula (Hospital Clínic i Provincial de Barcelona)
García, Maria Martinez (Consorci Sanitari de Terrassa)
Mestres, Gerard (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Melo, Martha (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Galindo, Alèxia Nebot (Consorci Sanitari del Maresme)
Sánchez-Migallón, Virginia (Hospital Universitari Vall d'Hebron)
Royo, David Valencia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Salillas, Lluís Toll (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Homs, Marta (Hospital Universitari Dexeus)
Raynard, Mireia (Hospital Universitari Dexeus)
Viscasillas Draper, Blanca (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Rodriguez-Cosmen, Cristina (Hospital del Mar (Barcelona, Catalunya))
Subirana Giménez, Laura (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Montero Gaig, Natàlia (Consorci Sanitari Integral)
Pacheco Comino, Nuria Lara (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bermejo Perez, Inés (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Santos Farré, Cristina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Alonso Gelabert, Arnau (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ribas, Patricia (Hospital Universitari Dexeus (Barcelona, Catalunya))
Teixell, Claudia (Hospital Universitari Dexeus (Barcelona, Catalunya))
Plaza Moral, Ana María (Hospital Clínic i Provincial de Barcelona)
Tena, Bea (Hospital Clínic i Provincial de Barcelona)
Fernández Castiñeira, Adrián (Hospital del Mar (Barcelona, Catalunya))
Armengol Gay, Mireia (Hospital del Mar (Barcelona, Catalunya))
Fort Pelai, Beatriz (Hospital del Mar (Barcelona, Catalunya))
García Bartoló, Carolina (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Mestre Iniesta, Carolina (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Peig Font, Anna (Consorci Sanitari de Terrassa)
Gil Esteller, Paula (Hospital Sant Joan de Déu (Esplugues de Llobregat, Catalunya))
Louis Clave, Jean (Hospital Universitari MútuaTerrassa)
Gasca Pera, Sandra (Hospital Universitari MútuaTerrassa)
Batalla González, Astrid (Institut de Recerca Sant Pau)
Vargas Raidi, Verónica (Consorci Sanitari del Maresme)
Universitat Autònoma de Barcelona. Departament de Medicina

Date:	2025
Abstract:	Background: 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. Methods: 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. Results: 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, p = 0. 01), elastomeric pump at 6 h at rest (2. 49 ± 2. 04 vs. 4. 10 ± 2. 86, ES -0. 733, p = 0. 04) and with movement (4. 44 ± 2. 41 vs. 6. 14 ± 3. 08, ES -0. 671, p = 0. 01) or epidural analgesia (4. 44 ± 2. 41 vs. 5. 65 ± 2. 57, ES -0. 496, p = 0. 02). No risk factors predicting poorer postoperative analgesia were found. Conclusions: 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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Analgesia ; Caesarean section ; Obstetric ; Pain ; Pain measurement ; Postoperative
Published in:	Journal of clinical medicine, Vol. 14, Num. 13 (7-1 2025) , art. 4638, ISSN 2077-0383

DOI: 10.3390/JCM14134638
PMID: 40649012

13 p, 837.9 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles