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The Association between Acute Postcesarean Pain and Length of Hospital Stay
Abstract Number: F5B-3
Abstract Type: Original Research
Acute pain after cesarean delivery is one of the most painful experiences of a mother's life. It is well known that postcesarean pain is a significant morbidity that affects not only the health of mothers but can impact the newborn's development which can delay hospital discharge (1).
Limited numbers of studies published thus far are deficient because of either a small sample size or not primarily focused on length of hospital stay. There are thus multiple mechanisms by which postoperative pain may delay hospital discharge (2). Nonetheless, the association between acute postcesarean pain and duration of delay hospital stay has yet to be formally evaluated.
Therefore, we aimed to determine the association between postcesarean pain and length of hospital stay. Specifically, we tested hypothesis that patients with high postcesarean pain scores have prolonged length of hospital stay.
We obtained data on singleton pregnancy undergoing elective cesarean section under spinal anesthesia at the University of Texas Medical Branch between 2013 and 2016. Incarcerated patients, chronic pain patients under pain medications were excluded from study. Our primary aim was to evaluate the association between average postoperative pain scores on length of hospital stay (defined as hours from admission to discharge).
The dataset consisted of 5350 patients admitted for delivery. In Model 1, we examined the association between average postoperative pain score and length of hospital stay (in hours), and we observed a significant association using a Bon-Ferroni corrected p-value of <0.025; every one-point increase in the average pain-score in the hospital stay was associated with a 30.6 [15.31, 45.80] hour increase in length of stay. In Model 2, we examined the impact of average pain on length of stay after adding the control variables listed, retaining only the significant variables. We found that the association between average pain score and hospital stay remained significant, every one-point increase in the average pain-score in the hospital stay was associated with a 23.45 [7.98, 38.91] hour increase in length of stay (Table 1).
Overall, we found an association between pain score and duration of hospital stay; those reporting higher average pain also tended to stay longer in the hospital.
1.Buhagiar, L, et al. Predictors of post-caesarean section pain and analgesic consumption. J Anes C Pharm.2011
2.Misal, US, et al Delayed recovery from anesthesia. Anesth Essays Res.2016