Monocentric Observational Study: Postoperative Pain After Cesarean Section: Incidence and Risk Factors.
Condition: Chronic Postoperative Pain; Cesarean Section Complications
MeSH terms: Pain, Postoperative
Study type: Observational

Summary: 
      The purpose of this prospective study was to assess chronic pain 3, and 12 months after
      cesarean delivery in a cohort of women in University hospital La Paz. We also aim to study
      the possible contribution of anesthetic and surgical risk factors for the development of
      Chronic post-surgical pain after cesarean (PCSCP)
    

Detailed description: 
      -  This prospective observational cohort study was conducted at University hospital La Paz.
           Women hospitalized for cesarean section from March 2017 to September 2018 were recruited
           on the hospital on the day of surgery, when research interviewers were available.
           Patients who agreed to participate were interviewed in person preoperatively,at
           discharge from Reanimation and 24 h postoperatively. Telephone follow-up interviews were
           conducted one week and 3,and 12 months following surgery. Intraoperative information was
           collected from the patient record or directly filled by a research person.
           Questionnaires applied in the present study are reflected in file 1.

        -  Study participants had to be aged between 18 and 50 years and American Society of
           Anesthesiologists scale (ASA) had to be I, II or III The exclusion criteria were history
           of major psychiatric disorder and inability to undertake a personal or telephone
           interview, ASA> III or dead fetus as result of caesarean section. The study was approved
           by the local ethics committee (registration number: PI-2564), and written informed
           consent was obtained from all patients.

      Questions about age, race, gestational age, toxic habits, body mass index (BMI) (that was
      calculated from height and weight) previous vaginal delivery, cesarean delivery, other
      demographic, medical, surgical, and pre- operative pain variables were included.

      -Were also recruited information about urgency level of caesarean using the classification
      proposed by Lucas et al.use of preoperative oxytocin, anesthesic technique before caesarean
      section (for example epidural for labor) and surgical and anesthesia variables.

      Patients were visited within 24 h after surgery. Pain intensity was assessed as average pain
      at rest and on movement during the past 24 h using (NRS) and DN2 questionnaire. Also
      analgesic consumption and relevant side effects or complications were annotated.

      Assessment after 3, and 12 months

      -Patients were contacted by telephone by one of the authors at 3, and 12 months following
      cesarean section. This telephone interview usually takes no longer than 15 min. Chronic
      postsurgical pain (CPSP) was measured using the short form Brief Pain Inventory (BPI) BPI
      assesses the severity of pain and its impact on functioning. The pain severity items are
      presented as numeric rating scale (NRS). The patients were asked to rate their pain at rest
      and during movement in the previous week of the survey. Items of pain interference on
      function (general activity, mood, walking, work, relations with others, sleep and enjoyment
      of life ) are also presented as numeric rating scale (NRS) , are valued with 0 = does not
      interfere and 10 = interferes completely. There were also questions consumption of analgesics
      and neuropathic pains symptoms using Neuropathic pain (DN2) questionnaire.
    

Intervention name(s): CESAREAN
Intervention type(s): Procedure
Intervention description(s): Women hospitalized for cesarean section
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Women hospitalized for cesarean section from March 2017 to September 2018 were recruited on
        the hospital on the day of surgery. Patients who agreed to participate and meet the
        inclusion criteria