The Relationship Between Patient-Controlled Analgesia and Postcesarean Section Pressure Ulcers: Analysis of Medical Record Data

Abstract

In this study, we aim to investigate the relationship between patient-controlled analgesia (PCA) and the incidence of pressure ulcer in postcesarean section mothers. A retrospective analysis was performed among consecutive cesarean section mothers in2016. Univariate and multivariate logistic regression was used to analyze the relationship between PCA and postcesarean section pressure ulcers. One thousand nine hundred eighteen cesarean section mothers were included in the study. Forty-five mothers (2.3%; 95% confidence interval [CI], 1.7%-3.1%) developed stage I pressure ulcer. The pressure ulcers were cured in 2 to 5days. Eighty percent (1,535) of mothers received PCA after cesarean section surgery. Pressure ulcer incidence was significantly higher in the PCA group compared with non-PCA groups (2.9% vs 0.0%, Fisher's exact P<.0001). Patient-controlled intravenous analgesia and patient-controlled epidural analgesia showed the same pressure ulcer risk (3.2% vs 2.6%, χ2=0.581, P=.446). After multivariate analysis by logistic regression, the adjusted odds ratio of PCA for pressure ulcer risk was 33.632, with a 95% CI of 25.061 to 45.134. Our results showed PCA was an independent risk factor for pressure ulcer in postcesarean section mothers. Although the pressure ulcers were all rated as stage I and can be cured in 2 to 5days, we still recommended some pressure ulcer prevention strategy should be used for these mothers.