The effect of fixed-time interval and on-demand analgesia protocols for post cesarean pain on maternal chronic pain and child development - follow up of randomized controlled trial
Abstract
OBJECTIVE
Post-cesarean delivery (CD) acute pain may progress to chronic pain, which may impair maternal bonding and child development.1,2 In 2013, we compared the efficacy of versus on-demand oral analgesia for post-caesarean pain in a randomized-controlled-trial.3 The fixed-time-interval group had received scheduled paracetamol, tramadol, and diclofenac regardless of pain level, and the on-demand group received medication as needed, with oxycodone reserved for unrelieved pain in both groups. We found that The 'fixed-time-interval' group had lower pain scores, higher satisfaction rate and more breastfeeds.4 We aimed to assess the long-term effects of the study protocols on maternal chronic pain and child development.
STUDY DESIGN
During September 2022 to January 2023, women who participated in the original study were approached by phone. The Brief Pain Inventory (BPI) was used to assess the presence and severity of mother's chronic pain and the impact on their functioning as was used in previous studies that assessed post-cesarean chronic pain.2 The child behavior checklist (CBCL) was filled by the mother and used to characterize child emotional and behavioral problems.1,4 CBCL assesses internalizing behaviors, externalizing behaviors, and total problems. T-scores>63 are considered clinically significant (pathologic range).5 The interviewer was blinded to the original group. The primary endpoints were chronic pain involving the CD scar area and rate of children within the…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 200 participants or records.
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