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///2015 Abstract Details
2015 Abstract Details2019-08-02T16:54:43-05:00

Modeling recovery from pain following non-emergent cesarean delivery

Abstract Number: GM-04
Abstract Type: Original Research

Jessica L Booth MD1 ; Emily E Sharpe MD2; Lynette C Harris BSN3; Carol Aschenbrenner MA4; Tim T Houle PhD5; James C Eisenach MD6

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

SOAP 2015