Characteristics and predictors of pain among women who underwent cesarean section in Fiji

Abstract

Aim: To identify the characteristics and predictors of post cesarean section (CS) pain among women. Materials & methods: This quantitative study was conducted at Labasa hospital in Fiji over a 6-month period. A total of 312 mothers who received spinal, epidural and general anesthesia were included. Their pain score was assessed using the visual analogue scale 24 h postoperatively. Results: 70.8% women had either moderate or severe pain on the visual analogue scale. About 41.3% women expressed dissatisfaction with their pain management and 70.5% women had difficulties in performing activities due to pain. Lower parity was noted to be a positive predictor of pain among women undergoing CS. Conclusion: Adequate pain management for post-CS patient at Labasa hospital is lacking.

Plain language summary

Pain & pain control methods after surgical birth in Labasa, Fiji

What is the study about?

This study looked at what affects pain in women after delivering a baby through surgery, also known as surgical birth or cesarean section (CS), at Labasa Hospital in Fiji. Over 6 months, 312 mothers who had surgical births with different types of pain-reducing medicines took part in this study. Their pain was checked 24 h after surgery using a pain scale.

What were the results?

The results showed that 70.8% of women felt moderate to severe pain after their surgical birth. In addition, 41.3% of the women were not happy with their pain control, and 70.5% had difficulties doing their daily activities because of the pain. The study also found that first-time mothers were more likely to feel more pain after their surgical birth.

What do the results mean?

The key point of the study is that many women at Labasa Hospital are not getting enough pain relief after their surgical birth, especially first-time mothers. This shows there is a need to improve pain control methods for these patients. A better pain control could help these mothers get better more comfortably and feel more satisfied with their care.

Article highlights

• This prospective quantitative study conducted over a 6-month period, aimed to identify post-cesarean section (CS) pain characteristics and predictors among pregnant women, offering insights into low-middle income countries pain management practices.

• A data sheet was created, utilizing the visual analogue scale, a 10 cm continuous scale anchored by ‘no pain’ and ‘worst imaginable pain,’ to assess pain intensity in various situations.

• A functional scoring system revealed the extent of pain-related limitations, providing insights into the impact of pain on daily activities.

• The study participants predominantly comprised young, married, I-Taukei women, reflecting the demographic profile of obstetric patients at Labasa Hospital.

• Of the 312 participants analyzed, 58.8% were aged 20–29 years and 75% belonged to the I-Taukei ethnic group.

• At 24 h postop, 70.5% of mothers experienced moderate to severe pain at rest, indicating a pressing need for improved pain control strategies.

• Primiparous status emerged as a significant predictor of heightened pain intensity post-CS (p < 0.002).

• The study highlights the pervasive impact of post-CS pain on daily activities, with a substantial portion of women unable to perform routine tasks due to pain, emphasizing the urgency of effective pain control strategies.

• The study recommends a multimodal opioid-based approach for post-CS pain management, aiming for cost–effectiveness and minimal side effects.

Keywords: :

• analgesia
• anesthesia
• cesarean section
• Fiji
• pain
• pain score
• postoperative

Acknowledgments

We would like to thank all the study participants and those who were very supportive for their valuable time and participation in the study.

Author contributions

R Narayan: Conceived and designed the experiments; performed the experiments; analyzed and interpreted the data; contributed reagents, materials, analysis tools or data; wrote the paper. M Mohammadnezhad, N Kumar, S Khan: methodology; analyzed and interpreted the data; contributed reagents, materials, analysis tools or data; wrote the paper.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Ethical conduct of research

Ethics approval was sought from the Fiji National University (FNU), College of Medicine, Nursing and Health Sciences- College Health Research Ethics Committee (CMNHS-CHREC) with the ID 134.19. Approval to conduct the audit was also sought from the Medical Superintendent of Labasa Hospital. Written informed consent (with rights to withdraw without any consequences), was taken from the patients and assurance of confidentiality and anonymity was provided to them throughout the course of the study and afterwards as well.