Management and impacts of acute post-cesarean section pain in a usual-risk maternity hospital: cross-sectional study
Manejo e impactos da dor aguda pós-cesariana em uma maternidade de risco habitual: estudo transversal
Milena Santos Pereira; Daniele Oliveira Silva; Fábia Laís Dias Carvalho; Juliana Santos Teles; Guilherme Reis de Santana Santos; Caíque Jordan Nunes Ribeiro
Abstract
BACKGROUND AND OBJECTIVES: Pain management during labor has been extensively explored, but few studies investigate acute postoperative pain following the cesarean section (APPC). The objective of this study was to analyze the management and impacts of APPC among postpartum women in the immediate postoperative period.
METHODS: This was a cross-sectional and analytical study, which employed questionnaires and documentary analysis. It was conducted between March and July 2023 in a philanthropic maternity hospital for low-risk pregnancies in Northeast Brazil, affiliated with the Brazilian Public Health System (SUS), and included postpartum women in the immediate postoperative period of cesarean section. This study outcomes were inadequate management of APPC and its impacts on the well-being and activities of postpartum women. Chi-square, Fisher’s Exact tests, MANOVA, Friedman’s ANOVA, Bonferroni post-hoc test, and Poisson regression were used for data analysis.
RESULTS: A total of 321 puerperal women were included, 232 of whom (72.3%) reported APPC. Both the prevalence of moderate to severe APPC and analgesic inadequacy was 38% (n=122). Painful experience in previous deliveries was independently associated with an 88% higher prevalence of analgesic inadequacy of the APPC (95% CI: 1.32-2.69; p=0.001), when adjusted for the age of the puerperae. Moderate to severe pain had an impact on activities such as sitting/standing, dressing, bathing, intimate hygiene, walking, breastfeeding, sleep, mood and the ability to enjoy life.
CONCLUSION: Inadequate management of APPC was associated with previous painful childbirth experience and negatively impacted the well-being and daily activities of postpartum women
Keywords
Resumo
JUSTIFICATIVA E OBJETIVOS: O manejo da dor durante o trabalho de parto normal tem sido amplamente explorado, mas poucos estudos investigam a dor aguda pós-cesariana (DAPC). O objetivo deste estudo foi analisar o manejo e os impactos da DAPC entre puérperas em pós-operatório mediato.
MÉTODOS: Trata-se de um estudo transversal e analítico, que empregou aplicação de formulário e análise documental, realizado no período de março a julho de 2023 em uma maternidade filantrópica de risco habitual do Nordeste do Brasil, conveniada ao Sistema Único de Saúde, que incluiu puérperas em pós-operatório mediato de cesariana. Os desfechos do estudo foram a inadequação analgésica da DAPC e seus impactos no bem-estar e nas atividades das puérperas. Os testes Qui-quadrado, Exato de Fisher, MANOVA, ANOVA de Friedman, pós-teste de Bonferroni e a regressão de Poisson foram utilizados na análise dos dados.
RESULTADOS: Foram incluídas 321 puérperas, dentre as quais 232 (72,3%) referiram DAPC. Tanto a prevalência de DAPC moderada à intensa quanto a de inadequação analgésica foram de 38% (n=122). A experiência dolorosa em partos prévios foi independentemente associada a uma prevalência 88% maior de inadequação analgésica da DAPC (IC 95%: 1,32-2,69; p=0,001), quando ajustada à idade das puérperas. A intensidade moderada à intensa da dor impactou atividades como se sentar/levantar-se, vestir-se, banhar-se, higiene íntima, deambulação, amamentação, o sono, o humor e a habilidade em apreciar a vida.
CONCLUSÃO: A inadequação analgésica da DAPC esteve diretamente associada à experiência dolorosa prévia e impactou o bem-estar e atividades da vida diária das puérperas.
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References
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Submitted date:
08/05/2024
Accepted date:
01/08/2025
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