Incidence And Predictors Of Postoperative Severe Acute Pain Within 24 Hours After Cesarean Section Performed Under Spinal Anesthesia At Public Hospitals In West Shoa, Ethiopia. 2022

Abstract

Background: Acute postoperative pain is common after a cesarean section, the mother suffers severe pain in the first 24 hours after the cesarean section compared to spontaneous birth, failure of the discovery of predictors of pain leads to maternal dissatisfaction, increased expenses, and restricted movement; increase the risk of deep vein thrombosis, lengthen hospital stay, and decrease social intimacy. Objective: To assess incidence and predictors of postoperative severe acute pain within 24 after cesarean section performed under spinal anesthesia at public hospitals in west shoa, Ethiopia. 2022. Methods: Institution-based prospective cohort study was conducted among 422 women who went to undergo cesarean section under spinal anesthesia at public hospitals of West Shoa, from July 30 to October 30. Participants were selected by systematic random sampling. Data were collected by structured questionnaire and collected data were entered into SPSS version 20 and exported into STATA 64 for analysis. The results were presented in tables, and figures. Risk factors were assessed by Poisson regression with robust standard error. Variables with a p-value of < 0.05 on multivariable Poisson regression with robust standard error analysis were considered statistically significant. Result; The overall incidence of severe postoperative pain after a cesarean section performed under spinal anesthesia within 24 h of follow-up was 50.4% (95% CI 40.7, 60.1). Preoperative anxiety risk ratio 1.7(CI: 1.4-2.0), preoperative pain risk ratio 1.3(CI: 1.0-1.48), type of incision risk ratio 11.3(CI: 1.1-1.6), spinal anesthesia without adjuvants risk ratio 4.1(CI: 1.5-10.9) and duration of surgery risk ratio 1.5(CI: 1.3- 1.8) were found to be predictors for postoperative severe acute pain after cesarean section performed under spinal anesthesia. Conclusion: In this study the overall incidence of severe acute pain after a cesarean section under spinal anesthesia was high. Preoperative fear, duration of the operation, preparatory pain, spinal anesthesia without the use of adjuvants, and the type of incision were risk factors for severe acute postoperative pain after a cesarean section under spinal anesthesia