Douleurs chroniques après césarienne : impact et facteurs de risque associés

Abstract

BackgroundChronic postoperative pain is a well-recognized problem after amputation, thoracotomy, mastectomy and inguinal hernia repair but has not been well evaluated after obstetric surgery. Study designRetrospective cohort. ObjectivesTo determine the rate of chronic pain after cesarean, their impact on quality of life of patients and risk factors associated with this complication. MethodsA questionnaire was sent to 220 consecutive patients who underwent caesarean delivery in a 6-month period. The questions focused on the duration of incisional pain after caesarean, severity and impact on daily activities. Meanwhile, a retrospective collection of clinical data (history, details of surgery and anaesthesia) was performed. After a descriptive analysis of the study population, a comparison of patients with and without DCPC was conducted to highlight potential risk factors. ResultsOne hundred and sixty-seven patients (76%) completed the survey. The average response time was 10months (range 8–12) after caesarean section. The postoperative pain was resoluted in most patients within three months but persisted in 25 patients (15%). Seven patients (4%) showed a deterioration of their quality of life because of daily moderate to severe incisional pain. Risk factors associated with chronic pain were the presence of acute pain in postoperative, pre-existing pain (headaches, back pain), a young age and the achievement of general anaesthesia without locoregional associated at caesarean section. ConclusionThe occurrence of chronic pain after cesarean section may be frequent and can be responsible for an impaired quality of life.