Prediction of outliers in pain, analgesia requirement, and recovery of function after childbirth: a prospective observational cohort study

British Journal of Anaesthesia
Ryu KomatsuPamela D Flood

Abstract

Prediction models to identify parturients who experience protracted pain, prolonged opioid use, and delayed self-assessed functional recovery are currently inadequate. For this study, 213 nulliparous women who planned vaginal delivery were enrolled and assessed daily until they completed three outcomes: (1) pain resolution; (2) opioid cessation; and (3) self-assessed functional recovery to predelivery level. The primary composite endpoint, 'pain and opioid-free functional recovery' was the time required to reach all three endpoints. The subjects were divided into two categories (the worst (longest time) 20% and remaining 80%) for reaching the primary composite endpoint, and each individual component. Prediction models for prolonged recovery were constructed using multivariate logistic regression with demographic, obstetric, psychological, and health-related quality of life characteristics as candidate predictors. Labour induction (vs spontaneous labour onset) predicted the worst 20% for the primary composite endpoint in the final multivariate model. Labour induction and higher postpartum day 1 numerical rating score for pain were predictors for being in the worst 20% for both functional recovery and pain burden. Labour type, de...Continue Reading

Associated Clinical Trials

Citations

Feb 11, 2020·International Anesthesiology Clinics·Erica HollandChloe Zera
May 16, 2019·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Beth D DarnallAmanda Wheeler
Jan 5, 2021·Current Opinion in Obstetrics & Gynecology·Pervez Sultan, Brendan Carvalho
Apr 2, 2021·International Journal of Obstetric Anesthesia·P Sultan, B Carvalho
Apr 19, 2021·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Andrew D WieseCarlos G Grijalva

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