Soares Anne Danielle Santos, Couceiro Tânia Cursino de Menezes, Lima Luciana Cavalcanti, Flores Fernanda Lobo Lago, Alcoforado Eusa Maria Belarmino, Filho Roberto de Oliveira Couceiro
Anesthesiologist, Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, PE, Brazil.
Holder of Superior Title in Anesthesiology (TSA); Master in Neuroscience, Universidade Federal de Pernambuco, Recife; Coordinator, IMIP, Recife, PE, Brazil.
Braz J Anesthesiol. 2013 Jul-Aug;63(4):317-21. doi: 10.1016/j.bjane.2012.12.001. Epub 2013 Aug 13.
Vaginal birth delivery may result in acute and persistent perineal pain postpartum. This study evaluated the association between catastrophizing, a phenomenon of poor psychological adjustment to pain leading the individual to magnify the painful experience making it more intense, and the incidence and severity of perineal pain and its relationship to perineal trauma.
Cohort study conducted with pregnant women in labor. We used the pain catastrophizing scale during hospitalization and assessed the degree of perineal lesion and pain severity in the first 24 hours and after 8 weeks of delivery using a numerical pain scale.
We evaluated 55 women, with acute pain reported by 69.1%, moderate/severe pain by 36.3%, and persistent pain by 14.5%. Catastrophizing mean score was 2.15 ± 1.24. Catastrophizing patients showed a 2.90 relative risk (RR) for perineal pain (95% CI: 1.08-7.75) and RR: 1.31 for developing persistent perineal pain (95% CI: 1.05-1.64). They also showed a RR: 2.2 for developing acute and severe perineal pain (95% CI: 1.11-4.33).
The incidence of acute and persistent perineal pain after vaginal delivery is high. Catastrophizing pregnant women are at increased risk for developing acute and persistent perineal pain, as well as severe pain. Perineal trauma increased the risk of persistent perineal pain.
经阴道分娩可能导致产后急性和持续性会阴疼痛。本研究评估了灾难化思维（一种对疼痛心理调适不良的现象，会导致个体放大疼痛体验，使其更强烈）与会阴疼痛的发生率和严重程度之间的关联，以及它与会阴创伤的关系。
对分娩期孕妇进行队列研究。我们在住院期间使用疼痛灾难化量表，并在分娩后24小时内及8周后使用数字疼痛量表评估会阴损伤程度和疼痛严重程度。
我们评估了55名女性，69.1%报告有急性疼痛，36.3%报告有中度/重度疼痛，14.5%报告有持续性疼痛。灾难化思维平均得分为2.15±1.24。有灾难化思维的患者发生会阴疼痛的相对风险（RR）为2.90（95%置信区间：1.08 - 7.75），发生持续性会阴疼痛的RR为1.31（95%置信区间：1.05 - 1.64）。她们发生急性和严重会阴疼痛的RR为2.2（95%置信区间：1.11 - 4.33）。
阴道分娩后急性和持续性会阴疼痛的发生率很高。有灾难化思维的孕妇发生急性和持续性会阴疼痛以及严重疼痛的风险增加。会阴创伤会增加持续性会阴疼痛的风险。
