Join now to get access to this content and more.
Become a SOAP member and have access to our benefits.
- For Review: SOAP Consensus Statement on Neuraxial Procedures in Thrombocytopenic Parturients
- Sample Centers of Excellence Applications
- ASA Corner
- SOAP Policy and Procedure Manual (P&P Manual)
- SOAP Expert Opinions
- SOAP's Learning Modules
- 2019 Annual Meeting Lecture Videos
- December 2018 - SOAP Unofficial Guide to ASA Committees Webinar
- Submit a Position
- View Job Postings
- Previous Meeting Archives
- Previous Meeting Abstract Search
- CMS Guidelines
- Member Benefits
- Newsletter Clinical Articles
- ACOG Documents
- Search our Patient Safety Archive
- Ask SOAP a Question
- Global Health Opportunities
- And more…
Modeling recovery from pain following non-emergent cesarean delivery
Abstract Number: GM-04
Abstract Type: Original Research
Introduction: Severity of acute pain while still in hospital following delivery is weakly associated with the risk of persistent pain and depression at 8 weeks postpartum (1). Although we know that recovery after surgery is a gradual process, there has been no high time-resolution examination of recovery from pain for the initial months after surgery, and none after cesarean delivery. Our goals were to determine the form of this time course and whether there are typical patterns of recovery.
Methods: Following IRB approval and informed consent, 346 ASA I-III parturients scheduled for non-emergent cesarean delivery were consented. Preoperative questionnaires, demographic information, and medical history were obtained. Routine anesthetic and postoperative analgesic care was provided. Pain intensity and unpleasantness scores (0-10) were recorded daily for 60 days after surgery by email or text messaging.
Results: To date, data from 155 parturients have been analyzed. Participants each provided a median [range] of 57 [1,61] daily pain scores (N = 7612). Worst daily pain scores over time were best fit by a ln(time) function, and preliminary latent class analysis identified 3 patterns of recovery (Figure 1). Consistent with previous, single time point observations, the majority of patients have no pain within one month after cesarean delivery, but a small subset of patients continue to have persistent pain 60 days postpartum.
Conclusions: These data suggest that high time resolution sampling of pain after surgery is feasible, that recovery from pain after cesarean delivery follows a ln(time) function, and that women can be divided into a small number of distinct groups of time courses. This approach has more biologic face validity than typical dichotomous definition of pain at arbitrary times and may develop as a more appropriate primary outcome measure to assess recovery from pain after surgery.
Reference: 1. Eisenach JC, et al. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain 2008:140;87-94.
Supported in part by R37 GM48085 to JCE