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The influence of preoperative epidural labor analgesia on postoperative pain in parturients undergoing emergent Cesarean section: a retrospective analysis
Abstract Number: T-17
Abstract Type: Original Research
Background: Preemptive analgesia attenuates pain–induced sensitization. Parturients who undergo emergent Cesarean section after experiencing labor pain are likely to develop pain–induced sensitization. We compared postoperative pain after Cesarean section among those parturients with or without preoperative epidural labor analgesia.
Methods: Medical database from February 2015 to September 2016 was searched, and 364 parturients, who had emergent Cesarean section under spinal anesthesia, were initially selected. After reviewing their medical records, parturients who underwent a trial of labor before emergent Cesarean section were finally enrolled in this study. Of those, parturients whose labor pain was managed with epidural analgesia were allocated to the ED group (n = 71) and parturients without epidural analgesia were assigned to the NED group (n = 43). Numeric rating scale (NRS) for postoperative pain, cumulative consumption of intravenous patient–controlled analgesia (PCA), and the number of rescue analgesic administration were compared between the two groups.
Results: The characteristics of patients, operation, and anesthesia were not different between the two groups. NRS for postoperative pain and cumulative consumption of intravenous PCA were comparable between two groups. However, significantly less patients of the ED group required rescue analgesics than those of the NED group (21% vs. 44% P = 0.047). Specifically, this different proportion was mainly observed on postoperative 6–24 h (7% vs. 33%, P = 0.011), whereas there were no differences on postoperative 0-6 h and on postoperative 24–48 h. The proportion of multiple rescue analgesic requirement (≥2 during admission period) was also significantly lower in the ED group than in the NED group (3% vs 26%, P = 0.022).
Conclusion: Although the pain score and PCA consumption were comparable between the two groups, rescue analgesics were significant less required in the ED group compared to the NED group. Epidural analgesia before Cesarean section seems to act as a preemptive analgesia for postoperative pain after Cesarean section.