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• W2106799433 abstract "Individual variability of postoperative pain is influenced by multiple factors, including sensitivity to pain, psychological factors, age and genetics. 1 Turk D.C. Okifuji A. Assessment of patients’ reporting of pain: an integrated perspective. Lancet. 1999; 352: 1784-1788 Abstract Full Text Full Text PDF Scopus (163) Google Scholar , 2 Bisgaard T. Klarskov B. Rosenberg J. Kehlet H. Characteristics and prediction of early pain after laparoscopic cholecystectomy. Pain. 2001; 90: 261-269 Abstract Full Text Full Text PDF PubMed Scopus (320) Google Scholar , 3 Pan P.H. Coghill R. Houle T. et al. Multifactorial preoperative predictors for post cesarean section pain and analgesic requirement. Anesthesiology. 2006; 104: 417-425 Crossref PubMed Scopus (207) Google Scholar Despite advances in postoperative pain management, postoperative pain relief and satisfaction are still inadequate in some patients because of individual variability and limitation from side effects of analgesic drugs or techniques. [4] Dolin S.T. Cashman J.N. Bland J.M. Effectiveness of acute postoperative pain management: I. Evidence from published data. Br J Anaesth. 2002; 89: 409-423 PubMed Scopus (0) Google Scholar Results from a recent US national survey suggest that a patient has a 50 to 71% chance of experiencing moderate to severe pain after surgery. [5] Apfelbaum J.L. Chen C. Mehta S.S. Gan T.J. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003; 97: 534-540 Crossref PubMed Scopus (1444) Google Scholar Recently, the Joint Commission on Accreditation of Healthcare Organizations established standards for pain assessment and treatment in healthcare facilities in the US with the goal to generate uniformly low pain scores of no more than 3 out of 10 both at rest and with movement. Cesarean delivery patients have even more compelling reasons to achieve optimal postoperative pain relief than other surgical patients but they also present with unique challenges. Post cesarean delivery patients are at a higher risk for thromboembolic events, which may also be precipitated by immobility from inadequate pain control or excessive sedation from opioids. Moreover, these women want to ambulate, to be alert and energetic enough to care for, interact with and breastfeed their newborn. With these goals in mind, the analgesic of choice requires minimal transfer in breast milk, little or no effect on neonates, minimal maternal side effects and minimal or no interference with caring for the newborn or discharge from hospital. Improved pain relief may improve postoperative outcomes whereas unsuppressed postoperative pain may lead to amplified pain responses and development of hyperalgesia and chronic pain, of which the incidence after cesarean delivery is unknown and currently under investigation. [6] Perkins F.M. Kehlet H. Chronic pain as an outcome of surgery: A review of predictive factors. Anesthesiology. 2000; 95: 1123-1133 Crossref Scopus (1076) Google Scholar Post caesarean delivery pain management: multimodal approachInternational Journal of Obstetric AnesthesiaVol. 16Issue 2PreviewWe read with interest Pan’s editorial on post caesarean delivery pain management.1 We agree with the conclusion that multimodal postoperative pain management offers the best quality of analgesia with high patient satisfaction and few side effects to mother or baby. The efficacy of multimodal analgesia has been compared with single drug therapy and been found to provide effective analgesia while reducing drug-related side effects.2–4 Full-Text PDF" @default.
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• W2106799433 date "2006-07-01" @default.
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• W2106799433 title "Post cesarean delivery pain management: multimodal approach" @default.
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• W2106799433 doi "https://doi.org/10.1016/j.ijoa.2006.04.004" @default.
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