Sistema de Salut de Catalunya
[Espinós Ramírez C] Hospital Universitari Germans Trias i Pujol, Badalona, Spain. Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya (UIC), Barcelona, Spain. [Roca Amatria G] Hospital Universitari Sagrat Cor, Barcelona, Spain. [Castellví Obiols P] Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya (UIC), Barcelona, Spain. [Martínez-Rodríguez D] Instituto Universitario de Matemática Multidisciplinar, Universitat Politècnica de València, Valencia, Spain. [Raynard M] Hospital Universitari Dexeus, Barcelona, Spain. [Viscasillas Draper B] Hospital Universitari Germans Trias i Pujol, Badalona, Spain. [Martinez García M, Peig Font A] Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya (UIC), Barcelona, Spain. Consorci Sanitari de Terrassa (CST), Terrassa, Spain. [Sánchez-Migallón V] Hospital Universitari Vall d'Hebron (HVH), Barcelona, Spain
Consorci Sanitari de Terrassa
2025-09-03T11:28:04Z
2025-09-03T11:28:04Z
2025-06-30
Analgesia; Post-operative pain; Caesarean delivery
Dolor postoperatori; Cesària; Analgèsia
Dolor postoperatorio; Cesárea; Analgesia
Caesarean section is considered one of the surgeries with the highest prevalence of postoperative pain, yet this is often underestimated and undertreated. This study was aimed at evaluating the prevalence and severity of postoperative pain, assessing which analgesic strategy is the most effective and identifying those risk factors associated with poorer analgesic results. Methods: A multi-centre observational study was conducted on 514 women undergoing elective caesarean section. The primary endpoints included postoperative pain severity at rest and with movement at 6 and 24 h. Results: The combination of intrathecal morphine and fentanyl with acetaminophen and Non Steroid Anti-inflammatory Drugs (NSAIDs) was associated with better pain control than any of the following treatments: intrathecal fentanyl with systemic acetaminophen and NSAIDs (2.49 ± 2.04 vs. 3.91 ± 2.75, ES = -0.610, p = 0.01), elastomeric pump at 6 h at rest (2.49 ± 2.04 vs. 4.10 ± 2.86, ES -0.733, p = 0.04) and with movement (4.44 ± 2.41 vs. 6.14 ± 3.08, ES -0.671, p = 0.01) or epidural analgesia (4.44 ± 2.41 vs. 5.65 ± 2.57, ES -0.496, p = 0.02). No risk factors predicting poorer postoperative analgesia were found. Conclusions: The prevalence of postoperative pain control after elective caesarean section is high. The best analgesic postoperative regimen includes intrathecal morphine together with fentanyl and systemic analgesics. No risk factors associated with poorer outcomes were found.
This work was supported by a grant from the Generalitat de Catalunya (G61737409) and the Hospital Universitari Germans Trias i Pujol (LT2403).
Article
Published version
English
Dolor postoperatori; Cesària (Operació); Analgèsia; DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications::Pain, Postoperative; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Obstetric Surgical Procedures::Delivery, Obstetric::Cesarean Section; HEALTH CARE::Health Services Administration::Patient Care Management::Disease Management::Pain Management; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Anesthesia and Analgesia::Analgesia; ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias::dolor posoperatorio; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos obstétricos::parto obstétrico::cesárea; ATENCIÓN DE SALUD::administración de los servicios de salud::gestión de la atención al paciente::tratamiento de las enfermedades::tratamiento del dolor; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::anestesia y analgesia::analgesia
MDPI
Journal of Clinical Medicine;14(13)
https://www.doi.org/10.3390/jcm14134638
Attribution-NonCommercial 4.0 International
https://creativecommons.org/licenses/by/4.0/
Articles científics - CST [139]
Articles científics - HVH [3427]
