Pain after cesarean section: do we have reliable predictors? Scoping review



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Abstract

BACKGROUND: Every year, the number of publications devoted to the study of various tools for predicting the intensity of pain after cesarean section is growing, which necessitated the generalization and systematization of these data.

OBJECTIVE: Our aim was to identify factors contributing to high-intensity pain after cesarean section (CS).

MATERIALS AND METHODS: a scoping review based on the PRISMA for Scoping Reviews (PRISMA-ScR) guidelines was conducted using PubMed, Cochrane Database of Systematic Reviews, and Google Scholar. The search was performed using the following keywords: “predictors” OR “prediction” OR “forecasting” AND “cesarean section” AND “pain”) in Russian and English, last search date November 30, 2022. The inclusion criteria for the review were formulated using the PICOD method: (P) population: postpartum women; (I) intervention: CS surgery; (C) comparison: surgical approach, anesthesia method, psychological status, pain threshold, genetic characteristics; (O) outcomes: pain intensity scores, analgesic requirements; (D) study design: prospective/retrospective cohort studies. Exclusion criteria were as follows: lack of sufficient data or outcome of interest; duplicate publication; chronic pain; publications devoted to pain relief during childbirth or pain after other surgical interventions; lack of full-text version; reviews and meta-analyses. The quality of selected non-randomized cohort studies was assessed using the Newcastle-Ottawa Scale (NOS).

RESULTS: 30 cohort studies were selected, involving 11,063 patients. Most studies were assigned an NOS score of 6 to 8, which was considered good quality. Two groups of factors were identified as predictors of the intensity of postoperative pain: factors associated with the characteristics of the patient (physical status, psychological status, individual pain threshold and pain tolerance, genetic characteristics) and factors associated with the characteristics of the operation and anesthesia.

CONCLUSION: the scoping review allowed us to identify reliable factors predicting high-intensity pain after CS, which should be taken into account when planning anesthesiological care for patients.

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About the authors

Nataliya V. Shindyapina

Razumovsky Saratov State Medical University, Saratov

Email: natalek-1111@mail.ru
ORCID iD: 0000-0002-7124-3697
SPIN-code: 6186-5930
Scopus Author ID: 57223182289

Assistant at the Department of Emergency, Anesthesiological and Resuscitation Care and Simulation Technologies in Medicine

Russian Federation, 112 Bolshaya Kazachya Str., 410012 Saratov, Russia

Dmitriy V. Marshalov

Razumovsky Saratov State Medical University, Saratov

Email: marshald@mail.ru
ORCID iD: 0000-0002-8774-0700
SPIN-code: 4682-2711
Scopus Author ID: 8860392900

MD, Dr. Sci. (Med.), associate professor of the Department of Emergency, Anesthesiological and Resuscitation Care and Simulation Technologies in Medicine

Russian Federation, 112 Bolshaya Kazachya Str., 410012 Saratov, Russia

Efim M. Shifman

Vladimirsky Moscow Regional Research Clinical Institute, Moscow; Pirogov Russian National Research Medical University, Moscow

Email: eshifman@mail.ru
ORCID iD: 0000-0002-6113-8498
SPIN-code: 4582-8494
Scopus Author ID: 58399983600

MD, Dr. Sci. (Med.), associate professor

129110, Moscow, st. Shchepkina, 61/2; 117513, Moscow, st. Ostrovityanova, house 1, building 6

Aleksandr V. Kuligin

Razumovsky Saratov State Medical University, Saratov

Author for correspondence.
Email: avkuligin@yandex.ru
ORCID iD: 0000-0001-5705-215X
SPIN-code: 1651-8142
Scopus Author ID: 57190874563

MD, Dr. Sci. (Med.), Head of the Department of Emergency Anesthesia and Resuscitation and Simulation Technologies in Medicine

Russian Federation, 112 Bolshaya Kazachya Str., 410012 Saratov, Russia

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