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. 2018 Apr 11:2018:2634768.
doi: 10.1155/2018/2634768. eCollection 2018.

Disparity between High Satisfaction and Severe Pain in Patients after Caesarean Section: A Prospective Observational-Controlled Investigation

Thomas Hesse  1 , Andreas Julich  1 , James Paul  2 , Klaus Hahnenkamp  1 , Taras I Usichenko  1   2
Affiliations

Disparity between High Satisfaction and Severe Pain in Patients after Caesarean Section: A Prospective Observational-Controlled Investigation

Thomas Hesse et al. Anesthesiol Res Pract. .

Abstract

Objectives: Recent advances in the treatment of postoperative pain (POP) have increased the quality of life in surgical patients. The aim of this study was to examine the quality of POP management in patients after CS in comparison with patients after comparable surgical procedures.

Methods: This was a prospective observational analysis in patients after CS in comparison with the patients of the same age, who underwent comparable abdominal gynaecological surgeries (GS group) at the university hospital. A standardised questionnaire including pain intensity on the Verbal Rating Scale (VRS-11), incidence of analgesia-related side effects, and incidence of pain interference with the items of quality of life and patients' satisfaction with the treatment of POP was used.

Results: Sixty-four patients after CS reported more pain on movement than the patients after GS (N=63): mean 6.1 versus 3.6 (VRS-11; P < 0.001). The patients after CS reported less nausea (8 versus 41%) and vomiting (3 versus 21%; P < 0.001) and demonstrated better satisfaction with POP treatment than the patients after GS: 1.4 (0.7) versus 1.7 (0.7) (mean (SD); VRS-5; P=0.02).

Conclusion: The disparity between the high level of pain and excellent satisfaction with POP treatment raises the ethical and biomedical considerations of restrictive pharmacological therapy of post-CS pain.

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Figures

Figure 1
Figure 1
Scheme of multimodal analgesia adjusted to the expected level of postoperative pain in patients after caesarian section at the university hospital of Greifswald. Piritramide is an opioid analgesic with 0.7 potency of morphine, used to treat acute postoperative pain in Germany.
Figure 2
Figure 2
(a) Pain levels and patients' satisfaction with pain treatment. A priori surgical pain is an anticipated procedure-specific POP intensity, depending on the size and localisation of surgical lesion defined according to [2]. Data are given as mean (SD); ∗ P < 0.0001; Student's t-test. (b) Frequency of opioid-induced side effects given as percent from the total number of patients in the audits; numeric values within the bars on the graph are absolute number of patients; ∗ P < 0.0001; χ 2 test.
See this image and copyright information in PMC

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