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Journal of Obstrectic Anaesthesia and Critical Care
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ORIGINAL ARTICLE
Year : 2023  |  Volume : 13  |  Issue : 1  |  Page : 9-16

Effect of age of gravida on post-cesarean section pain: An observational study


1 Department of Anaesthesiology and Critical Care, Dr. Ram Manohar Lohia Institute of Medical Sciences, Vibhuti Khand, Gomti Nagar, Lucknow, Uttar Pradesh, India
2 Department of Obstetrics and Gynecology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Vibhuti Khand, Gomti Nagar, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. Samiksha Parashar
Department of Anaesthesiology and Critical Care, Dr. Ram Manohar Lohia Institute of Medical Sciences, Vibhuti Khand, Gomti Nagar, Lucknow, Uttar Pradesh – 226 010
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JOACC.JOACC_11_22

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Objective: Preoperative identification of women at greater risk of post-cesarean pain might allow more intensive analgesic interventions. This study aimed to assess the effect of age of a parturient on post-cesarean section (CS) pain. Methods: 100 pregnant females were enrolled and divided into 4 groups: group A (age 18–24 years), group B (25–30 years), group C (31–35 years), and group D (≥36 years). Patient-controlled epidural analgesia was started postoperatively in all patients. Pain on a 0- to 10-point visual analog scale (VAS), a number of attempts tried for patient-activated dose delivery of ropivacaine, and successful delivery of patient-activated dose of ropivacaine were recorded for 72 hours. Breastfeeding was initiated as early as possible. The effect of breastfeeding on post-CS pain was observed for 72 hours in terms of increase, decrease, or no change in VAS scores with breastfeeding. Results: The peak VAS scores over 72 hours were 4.10 ± 0.60, 4.00 ± 0.67, 3.75 ± 0.45, and 3.42 ± 0.67, respectively, in groups A, B, C, and D, showing a significant declining trend (P = 0.007). The mean VAS scores decreased from 4.08 to 1.69 (group A, P < 0.0001), from 4.00 to 1.64 (group B, P < 0.0001), from 3.67 to 1.25 (group C, P < 0.0001), and from 3.33 to 1.50 (group D, P < 0.0001) over 72 hours. A statistically significant decline in patient-activated rescue drug delivery attempts, the number of times the rescue analgesic was delivered, and 24-h cumulative ropivacaine dose requirement was seen. Conclusions: In this study, it was found that post-cesarean pain decreases significantly with increasing age, as evidenced by reduced pain scores, reduced attempts at rescue drug delivery, and reduced rescue analgesic requirements.


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