Anxiety About Surgery and Anticipated Intraoperative Pain Independently Predict Pain During Extension of Epidural Analgesia for Intrapartum Cesarean Delivery: A Prospective Cohort Study

In Ho Lee; Hea-Jo Yoon; Dong Woo Kim

doi:doi:10.11648/j.ja.20180602.11

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Anxiety About Surgery and Anticipated Intraoperative Pain Independently Predict Pain During Extension of Epidural Analgesia for Intrapartum Cesarean Delivery: A Prospective Cohort Study

In Ho Lee, Hea-Jo Yoon, Dong Woo Kim

Published in Journal of Anesthesiology (Volume 6, Issue 2)

Received: 24 August 2018 Accepted: 6 September 2018 Published: 10 October 2018

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Abstract

Few studies have investigated the effects of preoperative psychological factors on pain during surgery. In this study, the association of preoperative psychological factors with the occurrence of intraoperative pain, the need for opioid supplementation, and the conversion to general anesthesia were examined during the extension of epidural analgesia for cesarean delivery. In parturients who received epidural labor analgesia, the visual analog scale (VAS; 0–100 mm) were used to evaluate trait anxiety, anxiety about surgery, and anticipated intraoperative pain before emergency cesarean delivery performed because of failure to progress. During surgery, the occurrence of intraoperative pain, need for opioid supplementation, and conversion to general anesthesia were observed. Spearman rank order correlation revealed a positive correlation between anxiety about surgery and the occurrence of intraoperative pain (correlation coefficient = 0.23, P = 0.008), between anticipated intraoperative pain and the occurrence of intraoperative pain (correlation coefficient = 0.31, P < 0.001), and between anticipated intraoperative pain and the need for opioid supplementation (correlation coefficient = 0.35, P = 0.012). Anxiety about surgery (odds ratio = 1.04 [1.02–1.07], P = 0.032) and anticipated intraoperative pain (odds ratio = 1.06 [1.02–1.11], P = 0.002) were independent predictors of the occurrence of intraoperative pain according to multiple logistic regression analysis, after controlling for maternal age and pain VAS score before cesarean delivery during labor pain. Anxiety about surgery and anticipated intraoperative pain are independent predictors of the occurrence of intraoperative pain during extension of epidural labor analgesia for intrapartum cesarean delivery performed because of failure to progress.

Published in	Journal of Anesthesiology (Volume 6, Issue 2)
DOI	10.11648/j.ja.20180602.11
Page(s)	45-49
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Anxiety, Cesarean Delivery, Epidural Labor Analgesia

References

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[3]	Kindler CH, Harms C, Amsler F, Ihde-Scholl T, Scheidegger D. The visual analog scale allows effective measurement of preoperative anxiety and detection of patients’ anesthetic concerns. Anesth Analg 2000; 90: 706–12.
[4]	Pan PH, Tonidandel AM, Aschenbrenner CA, Houle TT, Harris LC, Eisenach JC. Predicting acute pain after cesarean delivery using three simple questions. Anesthesiology 2013; 118: 1170–9.
[5]	Lucas DN, Yentis SM, Kinsella SM, Holdcroft A, May AE, Wee M, et al. Urgency of caesarean section: a new classification. J R Soc Med 2000; 93: 346–50.
[6]	Yoon HJ, Do SH, Yun YJ. Comparing epidural surgical anesthesia and spinal anesthesia following epidural labor analgesia for intrapartum cesarean section: a prospective randomized controlled trial. Korean J Anesthesiol 2017; 70: 412–9.
[7]	Lee TH, Marcantonio ER, Mangione CM, Thomas EJ, Polanczyk CA, Cook EF, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation 1999; 100: 1043–9.
[8]	Ip HY, Abrishami A, Peng PW, Wong J,Chung F. Predictors of postoperative pain and analgesic consumption: a qualitative systematic review. Anesthesiology 2009; 111: 657–77.
[9]	Lamberg L. Girls' and boys' differing response to pain starts early in their lives. JAMA 1998; 280: 1035–6.
[10]	Maranets I, Kain ZN. Preoperative anxiety and intraoperative anesthetic requirements. Anesth Analg 1999; 89: 1346.-51
[11]	Kil HK, Kim WO, Chung WY, Kim GH, Seo H, Hong JY. Preoperative anxiety and pain sensitivity are independent predictors of propofol and sevoflurane requirements in general anaesthesia. Br J Anaesth 2012; 108: 119–25.
[12]	Funcke S, Sauerlaender S, Pinnschmidt HO, Saugel B, Bremer K, Reuter DA, et al. Validation of innovative techniques for monitoring nociception during general anesthesia: a clinical study using tetanic and intracutaneous electrical stimulation. Anesthesiology 2017; 127: 272–83.
[13]	Bauer ME, Kountanis JA, Tsen LC, Greenfield ML, Mhyre JM. Risk factors for failed conversion of labor epidural analgesia to cesarean delivery anesthesia: a systematic review and meta-analysis of observational trials. Int J Obstet Anesth 2012; 21: 294–309.
[14]	Yoon HJ, Park SI. The relationship of preoperative anxiety with failure of extension of epidural analgesia for cesarean section. Anesth Pain Med 2015; 10: 271–7.
[15]	de Winter AF, Oldehinkel AJ, Veenstra R, Brunnekreef JA, Verhulst FC, Ormel J. Evaluation of non-response bias in mental health determinants and outcomes in a large sample of pre-adolescents. Eur J Epidemiol 2005; 20: 173–81.
[16]	Jeon JY, Yoon HJ, Lee IH, Jee YS, Lee PM. The effects of epidural analgesia on maternal fever and neonatal outcomes. Anesth Pain Med 2014; 9: 61–4.
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APA Style

In Ho Lee, Hea-Jo Yoon, Dong Woo Kim. (2018). Anxiety About Surgery and Anticipated Intraoperative Pain Independently Predict Pain During Extension of Epidural Analgesia for Intrapartum Cesarean Delivery: A Prospective Cohort Study. International Journal of Anesthesia and Clinical Medicine, 6(2), 45-49. https://doi.org/10.11648/j.ja.20180602.11

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ACS Style

In Ho Lee; Hea-Jo Yoon; Dong Woo Kim. Anxiety About Surgery and Anticipated Intraoperative Pain Independently Predict Pain During Extension of Epidural Analgesia for Intrapartum Cesarean Delivery: A Prospective Cohort Study. Int. J. Anesth. Clin. Med. 2018, 6(2), 45-49. doi: 10.11648/j.ja.20180602.11

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AMA Style

In Ho Lee, Hea-Jo Yoon, Dong Woo Kim. Anxiety About Surgery and Anticipated Intraoperative Pain Independently Predict Pain During Extension of Epidural Analgesia for Intrapartum Cesarean Delivery: A Prospective Cohort Study. Int J Anesth Clin Med. 2018;6(2):45-49. doi: 10.11648/j.ja.20180602.11

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@article{10.11648/j.ja.20180602.11,
  author = {In Ho Lee and Hea-Jo Yoon and Dong Woo Kim},
  title = {Anxiety About Surgery and Anticipated Intraoperative Pain Independently Predict Pain During Extension of Epidural Analgesia for Intrapartum Cesarean Delivery: A Prospective Cohort Study},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {6},
  number = {2},
  pages = {45-49},
  doi = {10.11648/j.ja.20180602.11},
  url = {https://doi.org/10.11648/j.ja.20180602.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20180602.11},
  abstract = {Few studies have investigated the effects of preoperative psychological factors on pain during surgery. In this study, the association of preoperative psychological factors with the occurrence of intraoperative pain, the need for opioid supplementation, and the conversion to general anesthesia were examined during the extension of epidural analgesia for cesarean delivery. In parturients who received epidural labor analgesia, the visual analog scale (VAS; 0–100 mm) were used to evaluate trait anxiety, anxiety about surgery, and anticipated intraoperative pain before emergency cesarean delivery performed because of failure to progress. During surgery, the occurrence of intraoperative pain, need for opioid supplementation, and conversion to general anesthesia were observed. Spearman rank order correlation revealed a positive correlation between anxiety about surgery and the occurrence of intraoperative pain (correlation coefficient = 0.23, P = 0.008), between anticipated intraoperative pain and the occurrence of intraoperative pain (correlation coefficient = 0.31, P < 0.001), and between anticipated intraoperative pain and the need for opioid supplementation (correlation coefficient = 0.35, P = 0.012). Anxiety about surgery (odds ratio = 1.04 [1.02–1.07], P = 0.032) and anticipated intraoperative pain (odds ratio = 1.06 [1.02–1.11], P = 0.002) were independent predictors of the occurrence of intraoperative pain according to multiple logistic regression analysis, after controlling for maternal age and pain VAS score before cesarean delivery during labor pain. Anxiety about surgery and anticipated intraoperative pain are independent predictors of the occurrence of intraoperative pain during extension of epidural labor analgesia for intrapartum cesarean delivery performed because of failure to progress.},
 year = {2018}
}

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TY  - JOUR
T1  - Anxiety About Surgery and Anticipated Intraoperative Pain Independently Predict Pain During Extension of Epidural Analgesia for Intrapartum Cesarean Delivery: A Prospective Cohort Study
AU  - In Ho Lee
AU  - Hea-Jo Yoon
AU  - Dong Woo Kim
Y1  - 2018/10/10
PY  - 2018
N1  - https://doi.org/10.11648/j.ja.20180602.11
DO  - 10.11648/j.ja.20180602.11
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 45
EP  - 49
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ja.20180602.11
AB  - Few studies have investigated the effects of preoperative psychological factors on pain during surgery. In this study, the association of preoperative psychological factors with the occurrence of intraoperative pain, the need for opioid supplementation, and the conversion to general anesthesia were examined during the extension of epidural analgesia for cesarean delivery. In parturients who received epidural labor analgesia, the visual analog scale (VAS; 0–100 mm) were used to evaluate trait anxiety, anxiety about surgery, and anticipated intraoperative pain before emergency cesarean delivery performed because of failure to progress. During surgery, the occurrence of intraoperative pain, need for opioid supplementation, and conversion to general anesthesia were observed. Spearman rank order correlation revealed a positive correlation between anxiety about surgery and the occurrence of intraoperative pain (correlation coefficient = 0.23, P = 0.008), between anticipated intraoperative pain and the occurrence of intraoperative pain (correlation coefficient = 0.31, P < 0.001), and between anticipated intraoperative pain and the need for opioid supplementation (correlation coefficient = 0.35, P = 0.012). Anxiety about surgery (odds ratio = 1.04 [1.02–1.07], P = 0.032) and anticipated intraoperative pain (odds ratio = 1.06 [1.02–1.11], P = 0.002) were independent predictors of the occurrence of intraoperative pain according to multiple logistic regression analysis, after controlling for maternal age and pain VAS score before cesarean delivery during labor pain. Anxiety about surgery and anticipated intraoperative pain are independent predictors of the occurrence of intraoperative pain during extension of epidural labor analgesia for intrapartum cesarean delivery performed because of failure to progress.
VL  - 6
IS  - 2
ER  -

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Author Information

In Ho Lee

Department of Anesthesiology and Pain Medicine, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, South Korea
Hea-Jo Yoon

Department of Anesthesiology and Pain Medicine, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, South Korea
Dong Woo Kim

Department of Anesthesiology and Pain Medicine, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, South Korea

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APA Style

In Ho Lee, Hea-Jo Yoon, Dong Woo Kim. (2018). Anxiety About Surgery and Anticipated Intraoperative Pain Independently Predict Pain During Extension of Epidural Analgesia for Intrapartum Cesarean Delivery: A Prospective Cohort Study. International Journal of Anesthesia and Clinical Medicine, 6(2), 45-49. https://doi.org/10.11648/j.ja.20180602.11

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ACS Style

In Ho Lee; Hea-Jo Yoon; Dong Woo Kim. Anxiety About Surgery and Anticipated Intraoperative Pain Independently Predict Pain During Extension of Epidural Analgesia for Intrapartum Cesarean Delivery: A Prospective Cohort Study. Int. J. Anesth. Clin. Med. 2018, 6(2), 45-49. doi: 10.11648/j.ja.20180602.11

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AMA Style

In Ho Lee, Hea-Jo Yoon, Dong Woo Kim. Anxiety About Surgery and Anticipated Intraoperative Pain Independently Predict Pain During Extension of Epidural Analgesia for Intrapartum Cesarean Delivery: A Prospective Cohort Study. Int J Anesth Clin Med. 2018;6(2):45-49. doi: 10.11648/j.ja.20180602.11

Copy | Download

@article{10.11648/j.ja.20180602.11,
  author = {In Ho Lee and Hea-Jo Yoon and Dong Woo Kim},
  title = {Anxiety About Surgery and Anticipated Intraoperative Pain Independently Predict Pain During Extension of Epidural Analgesia for Intrapartum Cesarean Delivery: A Prospective Cohort Study},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {6},
  number = {2},
  pages = {45-49},
  doi = {10.11648/j.ja.20180602.11},
  url = {https://doi.org/10.11648/j.ja.20180602.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20180602.11},
  abstract = {Few studies have investigated the effects of preoperative psychological factors on pain during surgery. In this study, the association of preoperative psychological factors with the occurrence of intraoperative pain, the need for opioid supplementation, and the conversion to general anesthesia were examined during the extension of epidural analgesia for cesarean delivery. In parturients who received epidural labor analgesia, the visual analog scale (VAS; 0–100 mm) were used to evaluate trait anxiety, anxiety about surgery, and anticipated intraoperative pain before emergency cesarean delivery performed because of failure to progress. During surgery, the occurrence of intraoperative pain, need for opioid supplementation, and conversion to general anesthesia were observed. Spearman rank order correlation revealed a positive correlation between anxiety about surgery and the occurrence of intraoperative pain (correlation coefficient = 0.23, P = 0.008), between anticipated intraoperative pain and the occurrence of intraoperative pain (correlation coefficient = 0.31, P < 0.001), and between anticipated intraoperative pain and the need for opioid supplementation (correlation coefficient = 0.35, P = 0.012). Anxiety about surgery (odds ratio = 1.04 [1.02–1.07], P = 0.032) and anticipated intraoperative pain (odds ratio = 1.06 [1.02–1.11], P = 0.002) were independent predictors of the occurrence of intraoperative pain according to multiple logistic regression analysis, after controlling for maternal age and pain VAS score before cesarean delivery during labor pain. Anxiety about surgery and anticipated intraoperative pain are independent predictors of the occurrence of intraoperative pain during extension of epidural labor analgesia for intrapartum cesarean delivery performed because of failure to progress.},
 year = {2018}
}

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TY  - JOUR
T1  - Anxiety About Surgery and Anticipated Intraoperative Pain Independently Predict Pain During Extension of Epidural Analgesia for Intrapartum Cesarean Delivery: A Prospective Cohort Study
AU  - In Ho Lee
AU  - Hea-Jo Yoon
AU  - Dong Woo Kim
Y1  - 2018/10/10
PY  - 2018
N1  - https://doi.org/10.11648/j.ja.20180602.11
DO  - 10.11648/j.ja.20180602.11
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 45
EP  - 49
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ja.20180602.11
AB  - Few studies have investigated the effects of preoperative psychological factors on pain during surgery. In this study, the association of preoperative psychological factors with the occurrence of intraoperative pain, the need for opioid supplementation, and the conversion to general anesthesia were examined during the extension of epidural analgesia for cesarean delivery. In parturients who received epidural labor analgesia, the visual analog scale (VAS; 0–100 mm) were used to evaluate trait anxiety, anxiety about surgery, and anticipated intraoperative pain before emergency cesarean delivery performed because of failure to progress. During surgery, the occurrence of intraoperative pain, need for opioid supplementation, and conversion to general anesthesia were observed. Spearman rank order correlation revealed a positive correlation between anxiety about surgery and the occurrence of intraoperative pain (correlation coefficient = 0.23, P = 0.008), between anticipated intraoperative pain and the occurrence of intraoperative pain (correlation coefficient = 0.31, P < 0.001), and between anticipated intraoperative pain and the need for opioid supplementation (correlation coefficient = 0.35, P = 0.012). Anxiety about surgery (odds ratio = 1.04 [1.02–1.07], P = 0.032) and anticipated intraoperative pain (odds ratio = 1.06 [1.02–1.11], P = 0.002) were independent predictors of the occurrence of intraoperative pain according to multiple logistic regression analysis, after controlling for maternal age and pain VAS score before cesarean delivery during labor pain. Anxiety about surgery and anticipated intraoperative pain are independent predictors of the occurrence of intraoperative pain during extension of epidural labor analgesia for intrapartum cesarean delivery performed because of failure to progress.
VL  - 6
IS  - 2
ER  -

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