Risk factors of inadequate pain control after cesarean delivery under neuraxial anesthesia
Journal Title: Journal of Air Force Medical University - Year 2023, Vol 44, Issue 4
Abstract
Objective To analyze the risk factors of inadequate pain control in parturients who received neuraxial anesthesia and underwent patient-controlled intravenous analgesia ( PCIA) after cesarean delivery ( CD). Methods The parturients who underwent CD in Xijing Hospital, Air Force Medical University from July 2017 to July 2020 were screened, and according to the 24 h postoperative activity pain score [using Numerical Rating Scale (NRS)], they were divided into no to mild pain (NRS 0 -3 points) group and moderate to severe pain (NRS 4 -10 points) group. Demographic, co-morbidity, obstetric and perioperative data of parturients in the two groups were collected. Univariate and multivariate logistic regression analysis was used to identify the risk factors that might be related to moderate to severe pain after CD. Results Finally, 2 254 cases were included for analysis, and 1 992 cases experienced moderate to severe pain, with an incidence of 88. 4%. Univariate logistic regression analysis showed that postoperative PCIA formula, preoperative combination of gestational diabetes mellitus (GDM), intraoperative combination of other operations, intraoperative epidural morphine, and intraoperative intravenous injection of non-steroid anti-inflammatory drugs (NSAIDs) were statistically associated with moderate to severe pain after CD (P <0. 01, P <0. 05). Multivariate logistic regression analysis showed that the following factors were associated with moderate to severe pain after CD: PCIA formula (P < 0. 001, OR = 0. 588, 95% CI: 0. 439 0. 788 in sufentanil + nalbuphine group; P = 0. 013, OR = 1. 828, 95% CI: 1. 136 2. 941 in fentanyl group), GDM (P = 0. 013, OR = 2. 262, 95% CI: 1. 184 4. 320), intraoperative epidural morphine ( P = 0. 023, OR = 0. 428, 95% CI: 0. 206 0. 889 ) and intraoperative intravenous injection of NSAIDs (P < 0. 001, OR = 0. 508, 95% CI: 0. 388 0. 665). Conclusion GDM is a risk factor of inadequate pain control after CD under neuraxial anesthesia. Intraoperative epidural morphine and intravenous injection of NSAIDs can reduce the occurrence of moderate to severe pain after CD. Compared with sufentanil or fentanyl, the combination of nalbuphine and sufentanil in PCIA formula can also reduce the occurrence of inadequate pain control.
Authors and Affiliations
WANG Yiting, WANG Lini, WANG Huan, NIE Huang
Keywords
Related Articles
- EP ID EP727782
- DOI -
- Views 34
- Downloads 0
Research progress in white matter genetic imaging biomarkers for screening people at high risk for schizophrenia
The global disease burden of schizophrenia is very heavy. The epidemiological survey of mental disorders in the PLA shows that schizophrenia has the highest prevalence rate, about 0. 16% , and is the most common cause o...
Immune response and intervention strategies of SARS-CoV-2 infection
Emerging viral pathogen infection has a significant impact on global public health security, social and economic development, and human life and health. Coronavirus disease 2019 (COVID-19) causes fever, headache, muscle...
Hypothesis of the mechanism of obesity leading to chronic disease
With the development of society, obesity is becoming more and more common, and the incidence of chronic diseases is also increasing, which brings heavy burden to the country and the general public. There are many kinds...
Effects of medium- and long-term sequelae of COVID-19 on flight personnel
Due to the increasing number of people recovering from coronavirus disease 2019 ( COVID-19), some patients may experience a variety of prolonged symptoms after recovery from acute disease, which is called “long COVID-19...
Consideration on the construction of evaluation index system for medical selection of military flight cadets
There is still no systematic quality evaluation system for the medical selection of military flight cadets. Based on the current situation, practical problems and reality needs of the medical selection of military fligh...