The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.
Predicting Acute Pain after Cesarean Delivery Using Three Simple Questions
Open accessAbstract
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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“A single-question approach has previously shown high predictive validity after cesarean delivery [85].”
From Pre- and post-operative psychological interventions to prevent pain and fatigue after breast cancer surgery (PREVENT): Protocol for a randomized controlled trial (2022) · cites this paper as [85]
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Citations
Cites
Predictors of Postoperative Pain and Analgesic Consumption: A Qualitative Systematic Review
Ip, H. Y. V., Abrishami, A., Peng, P. W. H., Wong, J., & Chung, F. (2009) · Anesthesiology · doi:10.1097/aln.0b013e3181aae87a · Cited by 1,055
Grace, S. L., Evindar, A., & Stewart, D. E. (2003) · Archives of Women's Mental Health · doi:10.1007/s00737-003-0024-6 · Cited by 923
Fear and anxiety: divergent effects on human pain thresholds
Rhudy, J. L., & Meagher, M. W. (2000) · Pain · doi:10.1016/s0304-3959(99)00183-9 · Cited by 913
Eisenach, J. C., Pan, P. H., Smiley, R. M., Lavand'homme, P. M., Landau, R., & Houle, T. T. (2008) · Pain · doi:10.1016/j.pain.2008.07.011 · Cited by 686
Self-citationStatistical Evaluation of a Biomarker
Ray, P., Manach, Y. L., Riou, B., Houle, T. T., & Warner, D. S. (2010) · Anesthesiology · doi:10.1097/aln.0b013e3181d47604 · Cited by 499
Granot, M., & Ferber, S. G. (2005) · The Clinical Journal of Pain · doi:10.1097/01.ajp.0000135236.12705.2d · Cited by 426
Psychosocial Factors and Surgical Outcomes: An Evidence-Based Literature Review
Rosenberger, P. H., Jokl, P., & Ickovics, J. R. (2006) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/00124635-200607000-00002 · Cited by 407
Recent Trends in Cesarean Delivery in the United States
Menacker, F., & Hamilton, B. E. (2010) · PsycEXTRA Dataset · doi:10.1037/e665412010-001 · Cited by 369
Multifactorial Preoperative Predictors for Postcesarean Section Pain and Analgesic Requirement
Pan, P. H., Coghill, R. C., Houle, T. T., Seid, M. H., Lindel, W. M., Parker, R. L., Washburn, S. A., Harris, L. C., & Eisenach, J. C. (2006) · Anesthesiology · doi:10.1097/00000542-200603000-00007 · Cited by 264
Self-citationPrediction of Postoperative Pain
Werner, M. U., Mjöbo, H. N., Nielsen, P. R., Rudin, A. Y., & Warner, D. S. (2010) · Anesthesiology · doi:10.1097/aln.0b013e3181dcd5a0 · Cited by 260
Cited by
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A Review of the Impact of Obstetric Anesthesia on Maternal and Neonatal Outcomes
Lim, G., Facco, F., Nathan, N., Waters, J. H., Wong, C. A., & Eltzschig, H. K. (2018) · Anesthesiology · doi:10.1097/aln.0000000000002182 · Cited by 235
Predicting Severity of Acute Pain After Cesarean Delivery: A Narrative Review
Gamez, B. H., & Habib, A. S. (2017) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000002658 · Cited by 111
Schnabel, A., Yahiaoui‐Doktor, M., Meißner, W., Zahn, P. K., & Pogatzki-Zahn, E. M. (2020) · PAIN Reports · doi:10.1097/pr9.0000000000000831 · Cited by 112
Predictors for Moderate to Severe Acute Postoperative Pain after Cesarean Section
Borges, N. D. C., Pereira, L. V., de Moura, L. A., Silva, T. C., & Pedroso, C. F. (2016) · Pain Research and Management · doi:10.1155/2016/5783817 · Cited by 104
Preoperative sleep quality predicts postoperative pain after planned caesarean delivery
Orbach‐Zinger, S., Fireman, S., Ben‐Haroush, A., Karoush, T., Klein, Z., Mazarib, N., Artyukh, A., Chen, R., Ioscovich, A., Eidelman, L. A., et al. (2016) · European Journal of Pain · doi:10.1002/ejp.980 · Cited by 74
Metadata
- 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)
- Venue
- Anesthesiology
- Published
- 2013-05
- Volume
- 118
- Issue
- 5
- Pages
- 1170-1179
- ISSN
- 0003-3022 (ISSN-L)
- 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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