Cited by 113Anesthesia and Pain ManagementPediatric Pain Management TechniquesMaternal and Perinatal Health Interventions

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Predicting Acute Pain after Cesarean Delivery Using Three Simple Questions

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Pan, Peter H., Tonidandel, Ashley M., Aschenbrenner, Carol A., Houle, Timothy T., Harris, Lynne C., Eisenach, James C.·2013·Anesthesiology

DOI 10.1097/aln.0b013e31828e156fPMC PMC3951732

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Abstract

BACKGROUND: Interindividual variability in postoperative pain presents a clinical challenge. Preoperative quantitative sensory testing is useful but time consuming in predicting postoperative pain intensity. The current study was conducted to develop and validate a predictive model of acute postcesarean pain using a simple three-item preoperative questionnaire. METHODS: A total of 200 women scheduled for elective cesarean delivery under subarachnoid anesthesia were enrolled (192 subjects analyzed). Patients were asked to rate the intensity of loudness of audio tones, their level of anxiety and anticipated pain, and analgesic need from surgery. Postoperatively, patients reported the intensity of evoked pain. Regression analysis was performed to generate a predictive model for pain from these measures. A validation cohort of 151 women was enrolled to test the reliability of the model (131 subjects analyzed). RESULTS: Responses from each of the three preoperative questions correlated moderately with 24-h evoked pain intensity (r = 0.24-0.33, P < 0.001). Audio tone rating added uniquely, but minimally, to the model and was not included in the predictive model. The multiple regression analysis yielded a statistically significant model (R = 0.20, P < 0.001), whereas the validation cohort showed reliably a very similar regression line (R = 0.18). In predicting the upper 20th percentile of evoked pain scores, the optimal cut point was 46.9 (z =0.24) such that sensitivity of 0.68 and specificity of 0.67 were as balanced as possible. CONCLUSIONS: This simple three-item questionnaire is useful to help predict postcesarean evoked pain intensity, and could be applied to further research and clinical application to tailor analgesic therapy to those who need it most.

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Authors: Pan, P. H., Tonidandel, A. M., Aschenbrenner, C. A., Houle, T. T., Harris, L. C., & Eisenach, J. C.
Affiliations: Professor
Assistant Professor
Biostatistician
Associate Professor
Research Coordinator
Wake Forest University Health Sciences (US)
ORCID: Houle, Timothy T.
Eisenach, James C.
Venue: Anesthesiology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2013-05
Volume: 118
Issue: 5
Pages: 1170-1179
ISSN: 0003-3022 (ISSN-L)
DOI: 10.1097/aln.0b013e31828e156f
PMC: PMC3951732
OpenAlex: W2033813026
Cited by: 113
References: 29
Citations by year: 2026: 7 · 2025: 10 · 2024: 6 · 2023: 9 · 2022: 9 · 2021: 21 · 2020: 9 · 2019: 9 · 2018: 11 · 2017: 4 · 2016: 7 · 2015: 8 · 2014: 2
FWCI: 5.58
Type: journal article
Language: en
Open access: green
europepmc.org
Locations: Anesthesiology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of General Medical Sciences (R01GM048085, R37GM048085, GM 48085)
National Center for Research Resources (M01RR007122)
Topics: Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords: postoperative pain, cesarean section, pain prediction, pain anticipation, anxiety, analgesic requirement, spinal anesthesia, prediction model
MeSH terms: Acoustic Stimulation, Adult, Anesthesia, Obstetrical, Anxiety, Cesarean Section, Female, Humans, Intraoperative Care, Postoperative Pain, Predictive Value of Tests, Pregnancy, Preoperative Care, Regression Analysis, Reproducibility of Results, Models, Statistical, Cohort Studies, Linear Models, Treatment Outcome, Young Adult, Acute Pain

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Predicting Acute Pain after Cesarean Delivery Using Three Simple Questions

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