Incidence of Pain during Cesarean Delivery with Neuraxial Anesthesia: An International, Prospective Cohort Study
Notice bibliographique
Résumé
BACKGROUND: Neuraxial anesthesia techniques are considered the preferred techniques for cesarean delivery; however, the true incidence of pain during cesarean delivery with neuraxial anesthesia is not currently known. To date, studies have been retrospective or conducted in a single center. The primary aim of this international cohort study was to prospectively determine the incidence of patient-reported pain during cesarean delivery with neuraxial anesthesia. METHODS: Over 8 weeks, a multicenter cohort study was conducted in 15 centers across the United States and Canada. All patients who underwent cesarean delivery with neuraxial anesthesia were surveyed on postpartum day 1 regarding the presence of intraoperative pain and were asked to grade their pain using a numeric rating score (0 to 10) and rate their satisfaction (yes or no) with their pain management. RESULTS: A total of 3,693 patients were included in the analysis. An overall incidence of patient-reported pain during cesarean delivery was 7.6% (95% confidence interval [CI], 6.8 to 8.5%) with 282 of 3,693 patients reporting pain. In patients undergoing elective cesarean delivery, intraoperative pain was reported in 3.7% (95% CI, 2.7 to 5.0%) with spinal, 9.2% (95% CI, 6.7 to 12.2%) with combined spinal-epidural, and 12.2% (95% CI, 4.1 to 26.2%) with epidural top-up anesthesia. In the non-elective setting, pain was more commonly reported by patients: 5.7% (95% CI, 4.0 to 7.8%) with spinal, 7.1% (95% CI, 4.7 to 10.1%) with combined spinal-epidural, 8.0% (95% CI, 2.2 to 19.2%) with dural puncture epidural, and 13.2% (95% CI, 11.1 to 15.5%) with epidural top-up anesthesia. Patients who had intraoperative pain reported a median (interquartile range) numeric rating score of 6 (4 to 8) out of 10. In those who reported pain, dissatisfaction with how the pain was managed by the anesthesia team was reported by 29 (10.3%) patients. CONCLUSIONS: The overall incidence of patient-reported pain during cesarean delivery with neuraxial anesthesia in this multicenter cohort was 7.6%. This varied significantly by anesthesia technique, with spinal having the lowest incidence and epidural top-up having the highest. Further work is required to characterize the pain experience, understand its impact, and develop techniques to reduce its incidence.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».