Incidence of Pain during Cesarean Delivery with Neuraxial Anesthesia: An International, Prospective Cohort Study
Authors' conclusion
The overall incidence of patient-reported pain during cesarean delivery with neuraxial anesthesia in this multicenter cohort was 7.6%. This varied significantly by anesthesia technique, with spinal having the lowest incidence and epidural top-up having the highest.
Study context
- Population
- Patients undergoing cesarean delivery with neuraxial anesthesia, 15 centers in the US and Canadaincluded in the analysis
- Participants
- 3,693 patients
- Outcome
- Incidence of patient-reported pain during cesarean delivery with neuraxial anesthesia
Methodological detailsinternational, multicenter, Conducted over 8 weeks
- International
- Multicenter
- Conducted over 8 weeks
Main finding
As reported in the abstract
Overall incidence
7.6%
282 of 3,693 patients; 95% CI 6.8 to 8.5%
Observational data: associations, not effects.
Further findings
Intraoperative pain by technique, elective cesarean delivery (subgroup)
- Spinal
- 3.7% (95% CI 2.7 to 5.0%)
- Combined spinal-epidural
- 9.2% (95% CI 6.7 to 12.2%)
- Epidural top-up
- 12.2% (95% CI 4.1 to 26.2%)
Intraoperative pain by technique, non-elective cesarean delivery (subgroup)
- Spinal
- 5.7% (95% CI 4.0 to 7.8%)
- Combined spinal-epidural
- 7.1% (95% CI 4.7 to 10.1%)
- Dural puncture epidural
- 8.0% (95% CI 2.2 to 19.2%)
- Epidural top-up
- 13.2% (95% CI 11.1 to 15.5%)
Pain NRS (0 to 10) in patients with intraoperative pain
- Median NRS (IQR 4 to 8)
- 6
Dissatisfaction with pain management by anesthesia team, among those with pain
- Dissatisfied patients, 29
- 10.3%
Original publication
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