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The Short-FormMcGill Pain Questionnaire-Revised to Evaluate Persistent Pain and Surgery-Related Symptoms in Healthy Women Undergoing a Planned Cesarean Delivery
  1. Clemens M. Ortner, MD, MS*,
  2. Dennis C. Turk, PhD*,
  3. Brian R. Theodore, PhD*,
  4. Monica M. Siaulys, MD, PhD,
  5. Laurant A. Bollag, MD* and
  6. Ruth Landau, MD*
  1. *Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA
  2. Department of Anesthesiology, Maternity Hospital Santa Joana, São Paulo, Brazil
  1. Address correspondence to: Clemens M. Ortner, MD, MS, Department of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific St, Suite BB1415, Box 356540, Seattle, WA 98195 (e-mail: cortner{at}uw.edu).

Abstract

Background and Objectives The incidence of chronic pain after cesarean delivery (CD) has been estimated to range between 0.3% and 18%. This wide range may be explained by differing study methodologies. Furthermore, a comprehensive characterization of pain quality is lacking. The aim of this study was to evaluate persistent pain in a healthy obstetric population undergoing planned CD and to provide a comprehensive description of pain quality.

Methods Three hundred eighty-one women with no pain history undergoing CD were included in this prospective, observational cohort study. Spinal anesthesia was standardized, and postoperative pain was recorded at 24 hours. In each woman, pain was assessed at 8 weeks, and 6 and 12 months using questionnaires of pain intensity and interference. Pain quality was assessed using the Short-Form McGill Pain Questionnaire–Revised.

Results The incidence of persistent pain at 8 weeks was 11% (95% confidence interval, 8%–14%), with pain reported as being mild and interfering with common daily activities by 32% of women. At 6 and 12 months, the incidence was 3% (95% confidence interval, 2%–6%) and 0.6% (95% confidence interval, 0%–2%) respectively, with pain rarely interfering with daily activities. However, 22% of women described other surgery-related symptoms at 12 months.

Conclusions The incidence of chronic pain at 12 months after planned CD is low (0.6%) and if present symptoms are mostly mild and not interfering with common daily activities. Using Short-Form McGill Pain Questionnaire–Revised, this study provides a comprehensive evaluation of pain quality that can be used as a basis in future post-CD pain trials.

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Footnotes

  • Funding: Departmental funding.

    This work was presented in part at the 2012 annual meeting of the Society for Obstetric Anesthesia and Perinatology held in Monterey, CA.

    The authors declare no conflict of interest.

    Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.rapm.org).

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