Background & Aims

Psychological factors such as anxiety, depression, and catastrophizing can increase the risk of chronic postsurgical pain. The purpose of this secondary analysis of a previously conducted clinical trial is to evaluate whether postpartum depression after cesarean delivery is associated with chronic postsurgical pain.

Methods

In the original study (MORPAIN trial), 290 patients undergoing cesarean delivery were randomized to receive either 100 µg intrathecal morphine or normal saline as an addition to their spinal anesthesia to study the relationship between intrathecal morphine and the development of chronic postsurgical pain. At eight weeks after delivery, the Edinburgh postnatal depression scale was used to identify patients with postpartum depression, using an established cutoff value of 11 or higher. The outcome of the study was the incidence of chronic postsurgical pain at 3 and 6 months after cesarean delivery.

Results

Out of the 276 patients included for analysis (14 patients were lost to follow-up), 24 (9%) experienced postpartum depression. The incidence of chronic postsurgical pain after six months was 15%. In a multivariable model, it was observed that the odds of experiencing chronic postsurgical pain after 6 months were significantly higher among patients with depression (adjusted odds ratio, 7.03 [95% CI, 2.62–18.82]; p <0.001) compared to those without depression.

Conclusions

After a cesarean delivery, patients with postpartum depression were more likely to experience chronic postsurgical pain.

References

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Presenting Author

Asish Subedi

Poster Authors

Asish Subedi

MD

BP Koirala Institute of Health Sciences

Lead Author

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Post-surgical/Post-traumatic Chronic Pain