Predictors for Moderate to Severe Acute Postoperative Pain after Cesarean Section

Background. Moderate to severe postoperative pain affects performance of daily activities and it contributes to persistent postoperative pain. In patients submitted to cesarean section, this pain can also interfere with women’s ability to care for their babies, to effectively breastfeed, and to satisfactorily interact with their children. Factors influencing the pain perception during the immediate postoperative period have not been widely pursued. Objective. To investigate the incidence and predicting factors of postoperative pain after cesarean section. Methods. A prospective longitudinal study with 1,062 women submitted to cesarean section. We collected sociodemographic, clinical, surgical, and health behavior data. We used the 11-point Numerical Pain and the Hospital Anxiety and Depression Scales. We performed logistic analysis to identify predictors of moderate to severe postoperative pain. Results. The incidence of moderate-severe postoperative pain was 78.4% (CI: 95%: 75.9%–80.8%). The preoperative anxiety (OR = 1.60; CI 95%: 1.22–2.30) and intrathecal morphine with fentanyl (OR = 0,23; CI 95%: 0.08–0.66) were significantly associated with moderate-severe postoperative pain report. Conclusion. The preoperative anxiety increases the risk of moderate-severe postoperative pain in women submitted to cesarean section. The intrathecal morphine with fentanyl added to bupivacaine was a protective factor against this pain.

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Faculty Opinions recommendation of The Effect of Adding Low-Dose Naloxone to Intrathecal Morphine on Postoperative Pain and Morphine Related Side Effects after Cesarean Section: A Double-Blind, Randomized, Clinical Trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.737592040.793577059 ◽

2020 ◽

Author(s):

Paul White

Keyword(s):

Clinical Trial ◽

Side Effects ◽

Postoperative Pain ◽

Cesarean Section ◽

Randomized Clinical Trial ◽

Low Dose ◽

Intrathecal Morphine ◽

Double Blind

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High resting heart rate protects against childhood risk factors in predicting adult psychopathy

Journal of Criminal Psychology ◽

10.1108/jcp-01-2021-0003 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

David P. Farrington ◽

Henriette Bergstrøm

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Longitudinal Study ◽

Protective Factor ◽

Psychosocial Risk Factors ◽

Psychosocial Risk ◽

Resting Heart Rate ◽

Prospective Longitudinal Study ◽

Content Type ◽

Prospective Longitudinal

Purpose Previous research has indicated that low resting heart rate (RHR), measured at age 18, predicts later psychopathy, and that high RHR acts as a protective factor in nullifying the influence of several psychosocial risk factors in predicting later antisocial and criminal outcomes. This paper aims to investigate high RHR as a protective factor against age 8–10 psychosocial risk factors in predicting psychopathy factors at age 48 (measured by the PCL:SV). Design/methodology/approach Data collected in the Cambridge Study in Delinquent Development are analyzed. This is a prospective longitudinal study of 411 London males from age 8 to age 61. Findings This paper first reports the age 8–10 psychosocial risk factors that predict the interpersonal/affective Factor 1 and the lifestyle/antisocial Factor 2. Then interaction effects with high RHR are studied. The results indicate that high RHR acts as a protective factor against a convicted father and a depressed mother in predicting both psychopathy factors. It also protected against harsh discipline, large family size, low verbal IQ, high hyperactivity, poor parental supervision and a high delinquency-rate school in predicting one of these psychopathy factors, and against a convicted mother in a sensitivity analysis. Originality/value This is the first ever longitudinal study showing that high RHR acts as a protective factor in the prediction of psychopathy. The replicated results with different antisocial outcomes show that more research is warranted on the protective effects of high RHR.

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Quality of postoperative pain management in Ethiopia: A prospective longitudinal study

PLoS ONE ◽

10.1371/journal.pone.0215563 ◽

2019 ◽

Vol 14 (5) ◽

pp. e0215563 ◽

Cited By ~ 3

Author(s):

Million Tesfaye Eshete ◽

Petra I. Baeumler ◽

Matthias Siebeck ◽

Markos Tesfaye ◽

Abraham Haileamlak ◽

...

Keyword(s):

Longitudinal Study ◽

Pain Management ◽

Postoperative Pain ◽

Postoperative Pain Management ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

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Changes in Cesarean section scar dimensions during pregnancy: a prospective longitudinal study

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.12334 ◽

2013 ◽

Vol 41 (5) ◽

pp. 556-562 ◽

Cited By ~ 24

Author(s):

O. Naji ◽

A. Daemen ◽

A. Smith ◽

Y. Abdallah ◽

S. Saso ◽

...

Keyword(s):

Longitudinal Study ◽

Cesarean Section ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

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Personality impacts fear of childbirth and subjective birth experiences: A prospective-longitudinal study

PLoS ONE ◽

10.1371/journal.pone.0258696 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0258696

Author(s):

Eva Asselmann ◽

Susan Garthus-Niegel ◽

Julia Martini

Keyword(s):

Cesarean Section ◽

Preterm Delivery ◽

Emotional Stability ◽

Fear Of Childbirth ◽

Prospective Longitudinal Study ◽

Targeted Interventions ◽

Emergency Cesarean Section ◽

Emergency Cesarean ◽

Birth Characteristics ◽

Prospective Longitudinal

Background Previous research suggests that less emotionally stable, less conscientious, less extraverted, and less agreeable women tend to suffer from higher fear of childbirth and experience their delivery as worse. Moreover, there is evidence that birth characteristics and unexpected incidents during delivery may impact women’s birth experiences. However, it remains unknown whether the role of personality in subjective birth experiences varies between women with different birth characteristics. Methods We used data from the Maternal Anxiety in Relation to Infant Development (MARI) Study, a regional-epidemiological study among pregnant women, who were prospectively followed up in multiple waves across the peripartum period. During pregnancy, personality was assessed with the short version of the Big Five Inventory. The Wijma Delivery Expectancy/ Experience Questionnaire was used to measure fear of childbirth (version A) during pregnancy and subjective birth experiences (version B) within the first 10 days after delivery. Results Linear regressions revealed that lower levels of emotional stability, agreeableness, and extraversion predicted higher fear of childbirth during pregnancy. Moreover, personality affected subjective birth experiences especially in women with specific birth characteristics: Lower emotional stability predicted worse subjective birth experiences in women with (vs. without) a preterm delivery, and higher conscientiousness predicted worse subjective birth experiences in women with an emergency cesarean section (vs. spontaneous delivery). Subjective birth experiences were also worse in less emotionally stable and less open women with (general) anesthesia (vs. no anesthesia) during delivery. Finally, higher emotional stability predicted a subjective birth experience that was worse than expected, particularly in multiparous women and women without anesthesia during delivery. Conclusions These findings suggest that less emotionally stable, less conscientious, and less open women tend to experience their delivery as worse particularly in case of unexpected incidents (i.e., preterm delivery, emergency cesarean section, and necessity of anesthetics) and might thus profit from early targeted interventions.

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OC14.01: Changes in Cesarean section scar dimensions during pregnancy: a prospective longitudinal study

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.11312 ◽

2012 ◽

Vol 40 (S1) ◽

pp. 28-29

Author(s):

O. Naji ◽

A. Daemen ◽

A. Smith ◽

Y. Abdallah ◽

S. Saso ◽

...

Keyword(s):

Longitudinal Study ◽

Cesarean Section ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

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Intraoperative Dexmedetomidine has no Effect on Postoperative Pain Scores for Posterior Spinal Fusion

The Open Anesthesia Journal ◽

10.2174/2589645802115010001 ◽

2021 ◽

Vol 15 (1) ◽

pp. 1-6

Author(s):

Rebecca A. Hong ◽

Aleda Leis ◽

James Weinberg ◽

G. Ying Li

Keyword(s):

Postoperative Pain ◽

Idiopathic Scoliosis ◽

Spinal Fusion ◽

Intrathecal Morphine ◽

Posterior Spinal Fusion ◽

P Value ◽

Pain Scores ◽

Significant Difference ◽

Severe Postoperative Pain ◽

Secondary Analyses

Background: Posterior Spinal Fusion (PSF) for idiopathic scoliosis results in severe postoperative pain. At our institution, a protocol for postoperative analgesia is followed, but anesthetic maintenance is decided by the anesthesiologist. Previous studies have shown that postoperative use of dexmedetomidine may improve analgesia for these patients, but the effect of intraoperative dexmedetomidine on postoperative pain scores remains unknown. Purpose: We sought to retrospectively compare pain scores from the Postoperative Anesthesia Care Unit (PACU) and from PACU discharge until midnight between PSF patients who did and did not receive intraoperative dexmedetomidine. Methods: After obtaining IRB approval, we retrospectively identified 79 patients aged 10-17 years who had undergone PSF for idiopathic scoliosis from June 2015-August 2018 and who received intrathecal morphine. Patients were then divided into two groups based on whether or not they received intraoperative dexmedetomidine. A multivariable linear regression model was constructed with the dependent variable of highest PACU pain score and exposure of interest intraoperative dexmedetomidine use. Secondary analyses were conducted similarly within those who received dexmedetomidine to examine the effects of dose on PACU pain scores, using a p-value < 0.05. Results: After adjusting for age, weight, sex, levels fused, intrathecal morphine, diazepam, and ketamine doses, there was no statistically significant difference in average PACU pain scores between those who did and did not receive intraoperative dexmedetomidine (β = -0.85, 95% CI: -2.48, 0.68; p = 0.31). Conclusion: Intraoperative use of dexmedetomidine during posterior spinal fusion for adolescent idiopathic scoliosis appears to have no effect on postoperative pain scores.

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Prevalence and incidence of mental health problems among Dutch medical students and the study-related and personal risk factors: a longitudinal study

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2015-0021 ◽

2016 ◽

Vol 28 (4) ◽

pp. 349-355 ◽

Cited By ~ 10

Author(s):

Jorien M. Borst ◽

Monique H.W. Frings-Dresen ◽

Judith K. Sluiter

Keyword(s):

Mental Health ◽

Longitudinal Study ◽

Medical Students ◽

Protective Factor ◽

Mental Health Problems ◽

Health Problems ◽

Personal Factors ◽

Prospective Longitudinal Study ◽

Symptoms Of Depression ◽

Prospective Longitudinal

Abstract Background: A high prevalence of mental health problems (i.e. depression and/or anxiety) has been found in medical students in comparison with the general population. Therefore, the objective was first to study the prevalence and 1-year incidence of symptoms of depression, anxiety and any mental health problems among Dutch medical students and, second, to study which study-related and personal factors present a risk of these mental health problems. Methods: A 1-year prospective longitudinal study was performed among medical students of two medical faculties in the Netherlands (n=951). Health problems and study-related and personal factors were measured with an online questionnaire. Mental health problems were assessed by depression and/or anxiety symptoms (BSI-DEP and BSI-ANG). Univariate and multivariate hierarchical logistic regression analyses were performed to examine which of the study-related and personal factors predict mental health problems. Results: At follow-up, 36%, 28% and 48% of the medical students reported symptoms of depression, anxiety and mental health problems, respectively. The incidence between 2010 and 2011 for depression was 20%, 17% for anxiety and 25% for mental health problems. Students who are worried about their own health during medical education are at an increased risk of future mental health problems (OR 2.0 [1.3–2.9], p=0.00). Excessive drinking behavior is a protective factor in this study (OR 0.7 [0.5–0.9], p=0.02). Conclusion: This study shows that only two out of nine factors are significantly associated with mental health problems among Dutch medical students, one risk factor and one protective factor.

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Interactions Between Resting Heart Rate and Childhood Risk Factors in Predicting Convictions and Antisocial Personality Scores

Crime & Delinquency ◽

10.1177/0011128720926108 ◽

2020 ◽

Vol 66 (10) ◽

pp. 1369-1391 ◽

Cited By ~ 2

Author(s):

David P. Farrington

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Protective Factor ◽

Biological Factor ◽

Resting Heart Rate ◽

Antisocial Personality ◽

Parental Discipline ◽

Prospective Longitudinal Study ◽

Childhood Risk Factors ◽

Prospective Longitudinal

This article analyzes data collected in the Cambridge Study in Delinquent Development, which is a prospective longitudinal study of 411 London males from Ages 8 to 61. It aims to investigate interactions between Age 8 and Age 10 psychosocial risk factors and a biological factor (resting heart rate), measured at Age 18, in predicting convictions up to Age 61 and high antisocial personality scores at Ages 32 and 48 (combined). The present analyses suggest that a high resting heart rate acted as a protective factor against harsh parental discipline and a depressed mother, or conversely that these childhood risk factors predicted antisocial outcomes only when they coincided with a low resting heart rate.

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