Jasim Hanan Hussein, Sulaiman Syed Azhar Bin Syed, Khan Amer Hayat, S Rajah Usha A/P
Student, Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Science, Penang, Pulau Pinang, Malaysia.
Professor, Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Science, Penang, Pulau Pinang, Malaysia.
J Clin Diagn Res. 2017 Sep;11(9):IC07-IC11. doi: 10.7860/JCDR/2017/25364.10630. Epub 2017 Sep 1.
INTRODUCTION: Caesarean section (CS) rate has increased considerably during the past years, accounting for 15% to 25% of births. During post-CS period, moderate to severe postoperative pain is a regularly reported problem. Ideally, the intensity of postoperative pain should be predicted so as to customize analgesia. AIM: To document the CS rate, assess the pain intensity and preoperative factors that may predict post caesarean pain among women in the Obstetric unit of a Hospital Pulau Pinang in Malaysia. MATERIALS AND METHODS: A retrospective chart review of 400 caesarean deliveries was conducted between January 2013 and June 2014. The study encompassed patient's demographic data and obstetrics data. The overall pain scores since the time of surgery (2, 4, 8, 12, 24 and 48 hours postoperatively at rest and while moving) were assessed by visual analogue scale (VAS). The data were analyzed by using SPSS software (version 21.0 for Windows). RESULTS: The results demonstrate that within a 48 hours postoperative period, the average pain at rest and while moving was 0.40±0.013 and 0.83±0.017 (VAS score), respectively. Logistic regression identified that a higher BMI (≥30) (OR 1.056; 95% CI=1.003 to 1.113, p=0.04), an increase in operation time (> 60 minutes) (OR 1.009; 95% CI=1.000 to 1.018, p=0.049), Single women (OR 11.597; 95% CI=1.382 to 97.320, p=0.024), blood group type O (OR 1.857; 95% CI=0.543 to 2.040, p = 0.001) and general anesthesia (OR 3.689; 95% CI=1.653 to 8.232, p=0.001) were found to be independent predictors for postcaesarean pain intensity. CONCLUSION: This study concluded that CS rate is 28% among women in the obstetric unit of a Hospital Pulau Pinang and the pain experienced by the study participants was mild. Moreover, the predictive factors for pain intensity may aid in identifying patients at greater risk for postoperative pain. This study concluded that the predictive methods proposed may aid in identifying patients at greater risk for postoperative pain.
引言:在过去几年中,剖宫产率大幅上升,占分娩总数的15%至25%。在剖宫产术后期间,中度至重度术后疼痛是经常报告的问题。理想情况下,应预测术后疼痛强度,以便定制镇痛方案。 目的:记录马来西亚槟城一家医院产科病房女性的剖宫产率,评估疼痛强度以及可能预测剖宫产术后疼痛的术前因素。 材料与方法:对2013年1月至2014年6月期间400例剖宫产分娩进行回顾性病历审查。该研究涵盖患者的人口统计学数据和产科数据。通过视觉模拟量表(VAS)评估自手术时起(术后2、4、8、12、24和48小时休息及活动时)的总体疼痛评分。使用SPSS软件(Windows版21.0)对数据进行分析。 结果:结果表明,在术后48小时内,休息和活动时的平均疼痛VAS评分别分为0.40±0.013和0.83±0.017。逻辑回归分析确定,较高的体重指数(≥30)(OR 1.056;95%CI=1.003至1.113,p=0.04)、手术时间增加(>60分钟)(OR 1.009;95%CI=1.000至1.018,p=0.049)、单身女性(OR 11.597;95%CI=1.382至97.320,p=0.024)、O型血(OR 1.857;95%CI=0.543至2.040,p = 0.001)和全身麻醉(OR 3.689;95%CI=1.653至8.232,p=0.001)是剖宫产术后疼痛强度的独立预测因素。 结论:本研究得出结论,槟城一家医院产科病房女性的剖宫产率为28%,研究参与者经历的疼痛较轻。此外,疼痛强度的预测因素可能有助于识别术后疼痛风险较高的患者。本研究得出结论,所提出的预测方法可能有助于识别术后疼痛风险较高的患者。
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