Pain during cesarean delivery: risk factors, mitigation, and current approaches.

IF 2.1 3区 医学 Q2 ANESTHESIOLOGY Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-04-01 DOI:10.1097/ACO.0000000000001488
Emily E Sharpe, Ruth Landau
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Abstract

Purpose of review: Pain during cesarean delivery (PDCD) has been overlooked and underreported and is associated with a traumatic birth experience and long-term morbidity. We review the studies reporting on PDCD and summarize available guidance providing roadmaps for anesthesiologists caring for patients during cesarean delivery.

Recent findings: PDCD is a patient-reported outcome and should not be defined by interventions mitigating insufficient neuraxial anesthesia, such as supplemental analgesic medication or general anesthesia. Depending on the cohorts studied and definitions used, current reported rates of PDCD range between 2 and 36%. Preoperative patient counseling, risk stratification, and testing of neuraxial block are mitigating strategies; ultimately, if pain occurs, it should be managed skillfully applying shared decision-making with a supportive follow-up to reduce psychological trauma. Statements from three international organizations offer guidance to prevent and treat PDCD.

Summary: This review provides strategies to mitigate the occurrence of PDCD, with targeted approaches to better prevent and manage PDCD.

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剖宫产疼痛:危险因素、缓解和当前方法
回顾目的:剖宫产疼痛(PDCD)一直被忽视和低估,并与创伤性分娩经历和长期发病率相关。我们回顾了关于剖宫产的研究报告,并总结了现有的指导方针,为麻醉医师护理剖宫产患者提供了路线图。最近的研究发现:PDCD是一种患者报告的结果,不应该通过缓解神经轴麻醉不足的干预措施来定义,例如补充镇痛药物或全身麻醉。根据研究的人群和使用的定义,目前报告的PDCD发病率在2%至36%之间。术前患者咨询、风险分层和检测神经轴传导阻滞是缓解策略;最终,如果发生疼痛,应该巧妙地管理,共同决策,并进行支持性随访,以减少心理创伤。三个国际组织的声明为预防和治疗PDCD提供了指导。摘要:本文综述了减轻PDCD发生的策略,并提出了有针对性的方法来更好地预防和管理PDCD。
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来源期刊
CiteScore
4.90
自引率
8.00%
发文量
207
审稿时长
12 months
期刊介绍: ​​​​​​​​Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Anesthesiology features hand-picked review articles from our team of expert editors. With fifteen disciplines published across the year – including cardiovascular anesthesiology, neuroanesthesia and pain medicine – every issue also contains annotated references detailing the merits of the most important papers.
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