Abstract

Cesarean section frequently is associated with different undesirable postoperative outcomes. Acute postoperative pain is one of the most frequent adverse outcomes that occur as the result of actual tissue damage. Previous studies have shown inconsistent results regarding the prevalence and predictors of acute postoperative pain. Therefore, this study aimed to assess the pooled prevalence and associated factors of postoperative pain after cesarean section with a systematic review and meta-analysis study that was performed on the basis of studies published within the last 10 years. After PubMed, Google Scholar, HINAR, Scopus, Web of Sciences, Cochrane, EMBASE, and gray literature extensive search for primary studies, their quality was assessed and data was extracted. STATAMP, version 17.0, was used for all possible analyses of the study. Twenty-eight studies were included in this systematic review and meta-analysis.
The pooled prevalence of postoperative pain was 58% (95% confidence interval [CI] 48%, 67%) with heterogeneity (I2 99.33%). Incision length >10 cm (odds ratio [OR] 2.34 [95% CI 1.71,
2.97]); spinal anesthesia without adjuvant (OR 3.45 [95% CI 1.56, 5.33]); general type of
anesthesia (OR 3.54 [95% CI 2.61, 4.48]); presence of preoperative anxiety (OR-1.73, 95% CI 1.12-2.35); and no peripheral nerve block (OR 3.23 [95% CI, 2.27-4.18]) were associated with the prevalence of postoperative pain significantly.
Therefore, the pooled prevalence of acute postoperative pain after cesarean section was high (58%), which needs more strategies for pain management.