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Predicting Postcesarean Delivery Pain

  • Obstetric Anesthesia (LR Leffert, Section Editor)
  • Published:
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Abstract

Poorly treated acute pain after cesarean delivery is associated with significant short-term and long-term morbidity in young women. Due to the importance of treating perioperative pain, more emphasis has been placed on improving postoperative pain management. However, individual differences in pain perception make postoperative pain management challenging after cesarean delivery. In this review, we will identify recent studies that have utilized a variety of preoperative tests to predict acute and/or chronic postoperative pain scores after cesarean delivery.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Eisenach JC, Pan PH, Smiley R, et al. Severity of acute pain after childbirth, but not type of delivery, predict persistent pain and postpartum depression. Pain. 2008;140:87–94.

    Article  Google Scholar 

  2. •• Abrishami A, Chan J, Chung F. Preoperative pain sensitivity and its correlation with postoperative pain and analgesic consumption. Anesthesiology. 2011;114:445–57. A systematic review of 15 studies addressing the effect of preoperative pain assessment in different surgical patients on postoperative pain scores.

  3. Werner MU, Mjobo H, Nielsen PR, Rudin A. Prediction of postoperative pain: a systematic review of predictive experimental pain studies. Anesthesiology. 2010;112:1494–502.

    Article  Google Scholar 

  4. Hsu Y, Somma J, Hung Y, et al. Predicting postoperative pain by preoperative pain assessment. Anesthesiology. 2005;103:613–8.

    Article  Google Scholar 

  5. Granot M. Can we predict persistent postoperative pain by testing preoperative experimental pain? Curr Opin Anaesthesiol. 2009;22:425–30.

    Article  Google Scholar 

  6. Granot M, Lowenstein L, Yarnitsky D, et al. Post-cesarean section pain prediction by preoperative experimental pain assessment. Anesthesiology. 2003;98:1422–6.

    Article  Google Scholar 

  7. Pan PH, Coghill R, Houle TT, et al. Multifactorial preoperative predictors for postcesarean section pain and analgesic requirements. Anesthesiology. 2006;104:417–25.

    Article  Google Scholar 

  8. Strulov L, Zimmer EZ, Granot M, et al. Pain catastrophizing, response to experimental heat stimuli, and post-cesarean section pain. J Pain. 2007;8:273–9.

    Article  Google Scholar 

  9. Granot M, Ferber SG. The roles of pain catastrophizing and anxiety in the prediction of postoperative pain intensity: a prospective study. Clin J Pain. 2005;21:439–45.

    Article  Google Scholar 

  10. Buhagiar LM, Cassar OA, Brincat MP, et al. Predictors of post-cesarean section pain and analgesic consumption. J Anaesthesiol Clin Pharmacol. 2011;27(2):185–91.

    Article  Google Scholar 

  11. Nielsen PR, Norgaard L, Rasmussen LS, et al. Prediction of postoperative pain by an electrical pain stimulus. Acta Anaesth Scand. 2007;51:582–6.

    Article  CAS  Google Scholar 

  12. Buhagiar LM, Cassar OA, Brincat MP, et al. Preoperative pain sensitivity: a prediction of post-operative outcome in the obstetric population. J Anaesthesiol Clin Pharmacol. 2013;29:465–71.

    Article  Google Scholar 

  13. Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152:S2–15.

    Article  Google Scholar 

  14. Wilder-Smith OH, Arendt-Nielsen L. Postoperative hyperalgesia: its clinical importance and relevance. Anesthesiology. 2006;104:601–7.

    Article  Google Scholar 

  15. • Ortner CM, Granot M, Richebe P, et al. Preoperative scar hyperalgesia is associated with post-operative pain in women undergoing a repeat cesarean delivery. Eur J Pain. 2013;17:111–23. Preoperative cesarean scar hyperalgesia is associated with central sensitization and increased postoperative pain scores after repeat cesarean delivery.

  16. Weissman-Fogel I, Granovsky Y, Crispel Y, et al. Enhanced presurgical pain temporal summation response predicts post-thoracotomy pain intensity during the acute postoperative phase. J Pain. 2009;10:628–36.

    Article  Google Scholar 

  17. •• Pan PH, Tonidandel AM, Aschenbrenner CA, et al. Predicting acute pain after cesarean delivery using three simple questions. Anesthesiology. 2013;118:1170–9. A simple three question survey can predict patients in the top 20th percentile for severe acute pain following cesarean delivery.

  18. Nikolajsen L, Sorensen HC, Jensen TS, Kehlet H. Chronic pain following cesarean section. Acta Anaesthesiol Scand. 2004;48:111–6.

    Article  CAS  Google Scholar 

  19. Rafique Z, Schibli KU, Russell IF, Lindow SW. A randomized controlled trial of the closure or non-closure of peritoneum at cesarean section: effect on post-operative pain. Br J Obstet Gynecol. 2002;109:694–8.

    Article  CAS  Google Scholar 

  20. Loos MJ, Scheltinga MR, Mulders LG, et al. The Pfannenstiel incision as a source of chronic pain. Obstet Gynecol. 2008;111:839–46.

    Article  Google Scholar 

  21. Yarnitsky D, Crispel Y, Eisenberg E, et al. Prediction of chronic post-operative pain: pre-operative DNIC testing identifies patients at risk. Pain. 2008;138(1):22–8.

    Article  Google Scholar 

  22. Li S, Sng BL, Allen J, et al. Evoked mechanical temporal summation, but not inefficient diffuse noxious inhibitory control, is a predictor of persistent post-cesarean section pain. Eur J Anaesthesiol. 2013;30:170.

    Google Scholar 

  23. Landau R, Kraft JC. Pharmacogenetics in obstetric anesthesia. Curr Opin Anesthesiol. 2010;23:323–9.

    Article  Google Scholar 

  24. Jubieta JK, Heitzeg MM, Smith YR, et al. COMT val158met genotype affects mu-opioid neurotransmitter responses to a pain stressor. Science. 2003;299:1240–3.

    Article  Google Scholar 

  25. Tan EC, Lim EC, Teo YY, et al. Ethnicity and OPRM variant independently predict pain perception and patient-controlled analgesia usage for postoperative pain. Mol Pain. 2009;5:32.

    Article  Google Scholar 

  26. Jensen KB, Lonsdorf TB, Schalling M, et al. Increased sensitivity to thermal pain following a single opiate dose is influenced by the COMT val(158)met polymorphism. PLoS One. 2009;4:e6016.

    Article  Google Scholar 

  27. • Landau R, Bollag L, Ortner C. Chronic pain after childbirth. Int J Obstet Anesth. 2013;22:133–45. Multiple factors influence the development of chronic pain after delivery, and management of acute pain after cesarean delivery is necessary to prevent the development of persistent pain.

  28. Landau R, Kraft JC, Flint LY, et al. An experimental paradigm for the prediction of post-operative pain (PPOP). J Vis Exp. 2010;35:e1671.

    Google Scholar 

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Correspondence to Jessica Booth.

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This article is part of the Topical Collection on Obstetric Anesthesia.

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Booth, J., Pan, P. Predicting Postcesarean Delivery Pain. Curr Anesthesiol Rep 5, 100–105 (2015). https://doi.org/10.1007/s40140-014-0087-0

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