Zaslansky, Ruth and Baumbach, Philipp and Edry, Ruth and Chetty, Sean and Lim, Siu Min and Schaub, Isabelle and Cruz, Jorge Jimenez and Meissner, Winfried and Stamer, Ulrike M. (2023) Following evidence-based recommendations for perioperative pain management after cesarean section is associated with better pain-related Outcomes: Analysis of registry data. Journal of Clinical Medicine, 12 (2). ISSN 2077-0383, DOI https://doi.org/10.3390/jcm12020676.
Full text not available from this repository.Abstract
Women who have had a Cesarean Section (CS) frequently report severe pain and pain-related interference. One reason for insufficient pain treatment might be inconsistent implementation of evidence-based guidelines. We assessed the association between implementing three elements of care recommended by guidelines for postoperative pain management and pain-related patient-reported outcomes (PROs) in women after CS. The analysis relied on an anonymized dataset of women undergoing CS, retrieved from PAIN OUT. PAIN OUT, an international perioperative pain registry, provides clinicians with treatment assessment methodology and tools for patients to assess multi-dimensional pain-related PROs on the first postoperative day. We examined whether the care included regional anesthesia with a neuraxial opioid OR general anesthesia with wound infiltration or a Transvesus Abdominis Plane block; ii] at least one non-opioid analgesic at the full daily dose; and iii] pain assessment and recording. Credit for care was given only if all three elements were administered (= ``full''); otherwise, it was ``incomplete''. A ``Pain Composite Score-total'' (PCStotal), evaluating outcomes of pain intensity, pain-related interference with function, and side-effects, was the primary endpoint in the total cohort (women receiving GA and/or RA) or a sub-group of women with RA only. Data from 5182 women was analyzed. ``Full'' care was administered to 20% of women in the total cohort and to 21% in the RA sub-group. In both groups, the PCStotal was significantly lower compared to ``incomplete'' care (p < 0.001); this was a small-to-moderate effect size. Administering all three elements of care was associated with better pain-related outcomes after CS. These should be straightforward and inexpensive for integration into routine care after CS. However, even in this group, a high proportion of women reported poor outcomes, indicating that additional work needs to be carried out to close the evidence-practice gap so that women who have undergone CS can be comfortable when caring for themselves and their newborn.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Anti-inflammatory agents non-steroidal; Caesarean section; Pain; Patient reported outcomes; Registry |
| Subjects: | R Medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Faculty of Medicine Faculty of Medicine > Anaesthesiology Department |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 19 Oct 2024 05:52 |
| Last Modified: | 19 Oct 2024 05:52 |
| URI: | http://eprints.um.edu.my/id/eprint/39150 |
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