Demilew Basazinew Chekol, Zurbachew Negesse, Getachew Nega, Mekete Getachew, Lema Diriba Teshome
Department of Anesthesia, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Anesthesia, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Pain Manag Nurs. 2024 Dec;25(6):e452-e464. doi: 10.1016/j.pmn.2024.05.010. Epub 2024 Jul 20.
Cesarean section frequently is associated with different undesirable postoperative outcomes. Acute postoperative pain is one of the most frequently experienced adverse outcomes that occurs as the result of actual tissue damage. Previous studies have shown inconsistent results regarding the prevalence and predictors of acute postoperative pain. Therefore, this study aimed to assess the pooled prevalence and associated factors of postoperative pain after cesarean section.
This is a systematic review and meta-analysis study that was performed on the basis of studies published within the last 10 years on the prevalence and associated factors of postoperative pain after cesarean section. After PubMed, Google Scholar, HINAR, Scopus, Web of Sciences, Cochrane, EMBASE, and gray literature extensive search for primary studies, their quality was assessed and data was extracted. STATA, version 17.0, was used for all possible analyses of the study.
Twenty-eight studies were included in this systematic review and meta-analysis. The pooled prevalence of postoperative pain was 58% (95% confidence interval [CI] 48%, 67%) with heterogeneity (I 99.33%). Incision length >10 centimeters (odds ratio [OR] 2.34 [95% CI 1.71, 2.97]); spinal anesthesia without adjuvant (OR 3.45 [95% CI 1.56, 5.33]); general type of anesthesia (OR 3.54 [95% CI 2.61, 4.48]); presence of preoperative anxiety (OR-1.73, 95% CI 1.12-2.35); and no peripheral nerve block (OR 3.23 [95% CI, 2.27-4.18]) were associated with the prevalence of postoperative pain significantly.
The pooled prevalence of acute postoperative pain after cesarean section was high (58%), which needs more strategies for pain management. Incision length >10 centimeters, spinal anesthesia without adjuvants, general type of anesthesia, preoperative anxiety, and no peripheral nerve block were significantly associated with this prevalence.
剖宫产术常常伴随着不同的不良术后结局。急性术后疼痛是因实际组织损伤而最常出现的不良结局之一。既往研究在急性术后疼痛的患病率及预测因素方面结果不一。因此，本研究旨在评估剖宫产术后疼痛的合并患病率及相关因素。
这是一项系统评价和荟萃分析研究，基于过去10年发表的关于剖宫产术后疼痛患病率及相关因素的研究开展。在对PubMed、谷歌学术、HINAR、Scopus、科学网、考克兰、EMBASE和灰色文献进行广泛检索以查找原始研究后，对其质量进行评估并提取数据。使用STATA 17.0版软件对本研究进行所有可能的分析。
本系统评价和荟萃分析纳入了28项研究。术后疼痛的合并患病率为58%（95%置信区间[CI] 48%，67%），存在异质性（I² = 99.33%）。切口长度>10厘米（比值比[OR] 2.34 [95% CI 1.71，2.97]）；无辅助用药的脊髓麻醉（OR 3.45 [95% CI 1.56，5.33]）；全身麻醉类型（OR 3.54 [95% CI 2.61，4.48]）；术前存在焦虑（OR -1.73，95% CI 1.12 - 2.35）；以及未进行外周神经阻滞（OR 3.23 [95% CI，2.27 - 4.18]）均与术后疼痛的患病率显著相关。
剖宫产术后急性疼痛的合并患病率较高（58%），这需要更多的疼痛管理策略。切口长度>10厘米、无辅助用药的脊髓麻醉、全身麻醉类型、术前焦虑以及未进行外周神经阻滞与该患病率显著相关。
