CoChat
Sign Up
Cited by 12Anesthesia and Pain ManagementMaternal and Perinatal Health InterventionsPain Management and Opioid Use

Comparison of Post-Cesarean Pain Perception of General Versus Regional Anesthesia, a Single-Center Study

Open access
Stanisic, Danka Mostic, Kalezic, Nevena, Rakic, Aleksandar, Rajovic, Nina, Mostic, Tatjana Ilic, Cumic, Jelena, Stulic, Jelena, Rudic Biljic Erski, Ivana +3 more·2022·Medicina
DOI 10.3390/medicina59010044PMC PMC9866267
Open this paper in CoChat — free accountOpen PDF

Abstract

Background and Objectives: Pain during and after the procedure remains the leading concern among women undergoing cesarean section. Numerous studies have concluded that the type of anesthesia used during a cesarean section undoubtedly affects the intensity and experience of pain after the operation. Materials and Methods: This prospective cohort study was conducted at the Clinic for Gynecology and Obstetrics, Clinical Center “Dragisa Misovic—Dedinje”, Belgrade, Serbia. Patients at term pregnancy (37–42 weeks of gestation) with an ASA I score who delivered under general (GEA) or regional anesthesia (RA) by cesarean section were included in the study. Following the procedure, we assessed pain using the Serbian McGill questionnaire (SF–MPQ), Visual Analogue Scale (VAS) and the pain attributes questionnaire at pre-established time intervals of 2, 12, and 24 h after the procedure. Additionally, time to patient’s functional recovery was noted. We also recorded the time to the first independent mobilization, first oral intake, and lactation establishment. Results: GEA was performed for 284 deliveries while RA was performed for 249. GEA had significantly higher postoperative sensory and affective pain levels within intervals of 2, 12, and 24 h after cesarean section. GEA had significantly higher postoperative VAS pain levels. On pain attribute scale intensity, GEA had significantly higher postoperative pain levels within all intervals. Patients who received RA had a shorter time to first oral food intake, first independent mobilization, and faster lactation onset in contrast to GEA. Conclusions: The application of RA presented superior postoperative pain relief, resulting in earlier mobilization, shorter time to first oral food intake, and faster lactation onset in contrast to GEA.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3390/medicina59010044

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • General anesthesia has been associated with higher postoperative pain and increased risk of postpartum depression compared with neuraxial anesthesia.

    “General anesthesia has been associated with higher postoperative pain and increased risk of PPD compared with neuraxial anesthesia.35,36”

    From Influence of Neuraxial Anesthesia Technique During Vaginal and Cesarean Delivery and Association with Postpartum Depression: A Narrative Review of Literature (2026) · cites this paper as [36]

    The Discussion reports higher post-cesarean pain scores with general than regional anesthesia. The Introduction says higher pain scores increase the risk of postpartum depression, but the paper does not report a direct comparison of depression risk between anesthesia groups. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • General anesthesia for cesarean delivery is consistently associated with higher rates of severe postpartum depression.

    “In contrast, general anesthesia for cesarean delivery is consistently associated with higher rates of severe postpartum depression.”

    From Influence of Neuraxial Anesthesia Technique During Vaginal and Cesarean Delivery and Association with Postpartum Depression: A Narrative Review of Literature (2026) · cites this paper as [36]

    The Discussion reports higher post-cesarean pain levels with general than regional anesthesia, and the Introduction says higher pain scores increase the risk of postpartum depression. The paper does not report depression rates by anesthesia type or establish a consistent association with severe postpartum depression. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 38

  1. [1]Nagy S. Papp Z. Global Approach of the Cesarean Section Rates J. Perinat. Med. 2021 49 1 4 10.1515/jpm-2020-0463 33055314 · DOI
  2. [2]Lavand’homme P. Postoperative Cesarean Pain: Real but Is It Preventable? Curr. Opin. Anesthesiol. 2018 31 262 267 10.1097/ACO.0000000000000585 29521684 · DOI
  3. [3]Carvalho B. Cohen S.E. Lipman S.S. Fuller A. Mathusamy A.D. Macario A. Patient Preferences for Anesthesia Outcomes Associated with Cesarean Delivery Anesth. Analg. 2005 101 1182 1187 10.1213/01.ane.0000167774.36833.99 16192541 · DOI
  4. [4]Smith A.J. Daly J. Arnolds D.E. Scavone B.M. Carvalho B. The Generalizability of Patients’ Preferences and Concerns Regarding Anesthesia Care for Cesarean Delivery: A Prospective Survey Anesthesiol. Res. Pract. 2021 2021 e9002061 10.1155/2021/9002061 34899902 PMC8660242 · DOI
  5. [5]Ortner C.M. Turk D.C. Theodore B.R. Siaulys M.M. Bollag L.A. Landau R. The Short-FormMcGill Pain Questionnaire-Revised to Evaluate Persistent Pain and Surgery-Related Symptoms in Healthy Women Undergoing a Planned Cesarean Delivery Reg. Anesth. Pain Med. 2014 39 478 486 10.1097/AAP.0000000000000158 25304476 · DOI
  6. [6]Babazade R. Vadhera R.B. Krishnamurthy P. Varma A. Doulatram G. Saade G.R. Turan A. Acute Postcesarean Pain Is Associated with In-Hospital Exclusive Breastfeeding, Length of Stay and Post-Partum Depression J. Clin. Anesth. 2020 62 109697 10.1016/j.jclinane.2019.109697 31899076 · DOI
  7. [7]Gamez B.H. Habib A.S. Predicting Severity of Acute Pain After Cesarean Delivery: A Narrative Review Anesth. Analg. 2018 126 1606 1614 10.1213/ANE.0000000000002658 29210789 · DOI
  8. [8]Niklasson B. Georgsson Öhman S. Segerdahl M. Blanck A. Risk Factors for Persistent Pain and Its Influence on Maternal Wellbeing after Cesarean Section Acta Obstet. Gynecol. Scand. 2015 94 622 628 10.1111/aogs.12613 25714852 · DOI
  9. [9]Chan C.L.-J. Tan C.W. Chan J.J.I. Sultana R. Chua T.-E. Chen H.Y. Sia A.T.H. Sng B.L. Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Prospective Study NDT 2020 16 715 727 10.2147/NDT.S241984 PMC7076713 32210566 · DOI
  10. [10]Karlström A. Engström-Olofsson R. Norbergh K.-G. Sjöling M. Hildingsson I. Postoperative Pain After Cesarean Birth Affects Breastfeeding and Infant Care J. Obstet. Gynecol. Neonatal Nurs. 2007 36 430 440 10.1111/j.1552-6909.2007.00160.x 17880313 · DOI
  11. [11]Nikolajsen L. Sørensen H. Jensen T. Kehlet H. Chronic Pain Following Caesarean Section Acta Anaesthesiol. Scand. 2004 48 111 116 10.1111/j.1399-6576.2004.00271.x 14674981 · DOI
  12. [12]Kessous R. Weintraub A.Y. Wiznitzer A. Zlotnik A. Pariente G. Polachek H. Press F. Aricha-Tamir B. Leizerovich A. Sheiner E. Spinal versus General Anesthesia in Cesarean Sections: The Effects on Postoperative Pain Perception Arch. Gynecol. Obstet. 2012 286 75 79 10.1007/s00404-012-2265-y 22382371 · DOI
  13. [13]Lai H.-Y. Tsai P.-S. Fan Y.-C. Huang C.-J. Anesthetic Practice for Caesarean Section and Factors Influencing Anesthesiologists’ Choice of Anesthesia: A Population-Based Study Acta Anaesthesiol. Scand. 2014 58 843 850 10.1111/aas.12350 24893619 · DOI
  14. [14]Granot M. Lowenstein L. Yarnitsky D. Tamir A. Zimmer E.Z. Postcesarean Section Pain Prediction by Preoperative Experimental Pain Assessment Anesthesiology 2003 98 1422 1426 10.1097/00000542-200306000-00018 12766652 · DOI
  15. [15]Mostic Stanisic D. Kalezic N. Rajovic N. Ilic Mostic T. Cumic J. Stanisavljevic T. Beleslin A. Stulic J. Rudic I. Divac N. Effect of regional vs general anesthesia on vital functions after caesarean section: A single center experience Hypertens Pregnancy 2022 1 6 10.1080/10641955.2022.2124417 36111407 · DOI
  16. [16]Carvalho B. Butwick A.J. Postcesarean delivery analgesia Best Pract. Res. Clin. Anaesthesiol. 2017 31 69 79 10.1016/j.bpa.2017.01.003 28625307 · DOI
  17. [17]Gerbershagen H.J. Aduckathil S. van Wijck A.J.M. Peelen L.M. Kalkman C.J. Meissner W. Pain Intensity on the First Day after Surgery: A Prospective Cohort Study Comparing 179 Surgical Procedures Anesthesiology 2013 118 934 944 10.1097/ALN.0b013e31828866b3 23392233 · DOI
  18. [18]Jasim H.H. Factors Affecting Post Caesarean Pain Intensity among Women in the Northern Peninsular of Malaysia JCDR 2017 10.7860/JCDR/2017/25364.10630 PMC5713759 29207737 · DOI
  19. [19]Delgado C. Ring L. Mushambi M.C. General Anaesthesia in Obstetrics BJA Educ. 2020 20 201 207 10.1016/j.bjae.2020.03.003 33456951 PMC7807964 · DOI
  20. [20]Ikeda T. Kato A. Bougaki M. Araki Y. Ohata T. Kawashima S. Imai Y. Ninagawa J. Oba K. Chang K. A Retrospective Review of 10-Year Trends in General Anesthesia for Cesarean Delivery at a University Hospital: The Impact of a Newly Launched Team on Obstetric Anesthesia Practice BMC Health Serv. Res. 2020 20 421 10.1186/s12913-020-05314-2 32404093 PMC7371464 · DOI
  21. [21]Stourac P. Blaha J. Klozova R. Noskova P. Seidlova D. Brozova L. Jarkovsky J. Anesthesia for Cesarean Delivery in the Czech Republic: A 2011 National Survey Anesth. Analg. 2015 120 1303 1308 10.1213/ANE.0000000000000572 25517197 · DOI
  22. [22]Sumikura H. Niwa H. Sato M. Nakamoto T. Asai T. Hagihira S. Rethinking General Anesthesia for Cesarean Section J. Anesth. 2016 30 268 273 10.1007/s00540-015-2099-4 26585767 · DOI
  23. [23]Guglielminotti J. Landau R. Li G. Adverse Events and Factors Associated with Potentially Avoidable Use of General Anesthesia in Cesarean Deliveries Anesthesiology 2019 130 912 922 10.1097/ALN.0000000000002629 30789362 PMC9922091 · DOI
  24. [24]Rollins M. Lucero J. Overview of Anesthetic Considerations for Cesarean Delivery Br. Med. Bull. 2012 101 105 125 10.1093/bmb/ldr050 22219238 · DOI
  25. [25]Traynor A.J. Aragon M. Ghosh D. Choi R.S. Dingmann C. Vu Tran Z. Bucklin B.A. Obstetric Anesthesia Workforce Survey: A 30-Year Update Anesth. Analg. 2016 122 1939 1946 10.1213/ANE.0000000000001204 27088993 · DOI
  26. [26]Gori F. Pasqualucci A. Corradetti F. Milli M. Peduto V.A. Maternal and Neonatal Outcome after Cesarean Section: The Impact of Anesthesia J. Matern. Fetal Neonatal Med. 2007 20 53 57 10.1080/14767050601134645 17437200 · DOI
  27. [27]Jenkins J.G. Khan M.M. Anaesthesia for Caesarean Section: A Survey in a UK Region from 1992 to 2002 Anaesthesia 2003 58 1114 1118 10.1046/j.1365-2044.2003.03446.x 14616600 · DOI
  28. [28]Ring L. Landau R. Delgado C. The Current Role of General Anesthesia for Cesarean Delivery Curr. Anesthesiol. Rep. 2021 11 18 27 10.1007/s40140-021-00437-6 33642943 PMC7902754 · DOI · Paper page
  29. [29]Wang J.J. Ho S.T. Liu H.S. Tzeng J.I. Tze T.S. Liaw W.J. The Preemptive Effect of Regional Anesthesia on Post-Cesarean Section Pain Acta Anaesthesiol. Sin. 1995 33 211 216 8705153
  30. [30]Lertakyamanee J. Chinachoti T. Tritrakarn T. Muangkasem J. Somboonnanonda A. Kolatat T. Comparison of General and Regional Anesthesia for Cesarean Section: Success Rate, Blood Loss and Satisfaction from a Randomized Trial J. Med. Assoc. Thai. 1999 82 672 680 10511769
  31. [31]Al-Husban N. Elmuhtaseb M.S. Al-Husban H. Nabhan M. Abuhalaweh H. Alkhatib Y.M. Yousef M. Aloran B. Elyyan Y. Alghazo A. Anesthesia for Cesarean Section: Retrospective Comparative Study Int. J. Womens Health 2021 13 141 152 10.2147/IJWH.S292434 33564269 PMC7866905 · DOI
  32. [32]Zandomenico J.G. Perito G.Z. Machado J.A. Silva H.C.G.E. Postoperative pain management after cesarean delivery: Cross-sectional study Braz. J. Anesthesiol. 2022 72 533 535 10.1016/j.bjane.2021.10.020 35121061 PMC9373598 · DOI
  33. [33]Kintu A. Abdulla S. Lubikire A. Nabukenya M.T. Igaga E. Bulamba F. Semakula D. Olufolabi A.J. Postoperative pain after cesarean section: Assessment and management in a tertiary hospital in a low-income country BMC Health Serv. Res. 2019 19 68 10.1186/s12913-019-3911-x 30683083 PMC6347795 · DOI
  34. [34]Roofthooft E. Joshi G.P. Rawal N. Van de Velde M. PROSPECT Working Group of the European Society of Regional Anaesthesia and Pain Therapy and supported by the Obstetric Anaesthetists’ Association PROSPECT guideline for elective caesarean section: Updated systematic review and procedure-specific postoperative pain management recommendations Anaesthesia 2021 76 665 680 10.1111/anae.15339 33370462 PMC8048441 · DOI
  35. [36]Alus Tokat M. Serçekuş P. Yenal K. Okumuş H. Early Postpartum Breast-Feeding Outcomes and Breast-Feeding Self-Efficacy in Turkish Mothers Undergoing Vaginal Birth or Cesarean Birth with Different Types of Anesthesia Int. J. Nurs. Knowl. 2015 26 73 79 10.1111/2047-3095.12037 24897921 · DOI
  36. [37]Huang H. Wang H. He M. Early Oral Feeding Compared with Delayed Oral Feeding after Cesarean Section: A Meta-Analysis J. Matern.-Fetal Neonatal Med. 2016 29 423 429 10.3109/14767058.2014.1002765 25754213 · DOI
  37. [38]Prokopowicz A. Korzeniewska A. Byrka K. Patient Anxiety of Verticalization on Day 0 after a Cesarean Section Arch. Gynecol. Obstet. 2021 303 391 399 10.1007/s00404-020-05748-3 32856137 PMC7858551 · DOI
  38. [39]Ghaffari S. Dehghanpisheh L. Tavakkoli F. Mahmoudi H. The Effect of Spinal versus General Anesthesia on Quality of Life in Women Undergoing Cesarean Delivery on Maternal Request Cureus 2018 10 e3715 10.7759/cureus.3715 30788204 PMC6373886 · DOI

Cited by

Sorted by citations

Authors
Stanisic, D. M., Kalezic, N., Rakic, A., Rajovic, N., Mostic, T. I., Cumic, J., Stulic, J., Rudic Biljic Erski, I., Divac, N., Milic, N., & Stojanovic, R.
Affiliations
  • Clinic for Gynecology and Obstetrics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
  • University of Belgrade (RS)
  • Clinic of Gynecology and Obstetrics “Narodni Front”, 11000 Belgrade, Serbia
  • Institute for Medical Statistics and Informatics, Faculty of Medicine University of Belgrade, 11000 Belgrade, Serbia
  • Univerzitetski Klinički Centar Srbije (RS)
  • Mayo Clinic (US)
  • Institute for Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
ORCID
Venue
Medicina
Publisher
MDPI AG
Published
2022-12-27
Volume
59
Issue
1
Pages
44
ISSN
  • 1010-660X (ISSN-L)
  • 1648-9144
DOI
10.3390/medicina59010044
PMC
PMC9866267
OpenAlex
W4313245488
Cited by
12
References
1
Citations by year
2026: 1 · 2025: 4 · 2024: 6 · 2023: 1
FWCI
2.57
Type
journal article
Language
en
Open access
Licence
Locations
  • Medicina (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
cesarean section, postoperative pain, general anesthesia, regional anesthesia, epidural anesthesia, functional recovery, mobilization, oral intake, lactation onset, McGill Pain Questionnaire, visual analogue scale
MeSH terms
Analgesics, Opioid, Anesthesia, Conduction, Anesthesia, General, Cesarean Section, Female, Humans, Postoperative Pain, Pregnancy, Prospective Studies, Pain Perception

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review