Journal of pain research · 2026
Postoperative Analgesic Practices and Pain Control Outcomes After Caesarean Delivery: A Cross-Sectional Survey of 215 Hospitals in Hubei Province, China.
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Chen Jing, Wang Yu, Hu Li, Liu Yuwei, Chen Qinghong, Han Dong, Yao Shanglong, Wu Jing
Аннотация
OBJECTIVE: This study aimed to explore the spectrum of analgesic regimens, their effectiveness, and related adverse events following cesarean sections (CS) in Hubei Province, China, to provide an evidence base for refining post-CS pain management.
METHODS: This facility-based cross-sectional study used aggregate institutional data submitted by department heads through the Hubei Anesthesia Quality Control and Service Cloud Platform. The analgesic practice (the utilization of intravenous analgesia and epidural analgesia and corresponding medication regimens), their effects (the incidence of inadequate analgesia), and safety profiles (the incidence of adverse reactions) of different pain management strategy following CS were collected for analyses. The primary outcome was the incidence of inadequate analgesia, which was defined as a Visual Analog Scale (VAS) score of ≥4 points within 48 hours. Unadjusted comparisons between groups were performed using chi-square tests and Spearman's rank correlation; multivariable logistic regression was additionally applied to adjust for institutional-level covariates.
RESULTS: 36,620 CS cases were included in our analysis. Intravenous analgesia was the most common strategy (21,142 cases, 57.7%), followed by epidural analgesia (8569 cases, 23.4%). Despite its widespread use, our unadjusted comparison indicated that intravenous analgesia had significantly higher rates of inadequate pain control (VAS ≥4) than epidural analgesia (3.94% vs. 2.21%, p<0.001). Measurable disparities in analgesic practices and pain control outcomes across hospitals of different tiers and cities with different levels of economic development in Hubei Province were also observed.
CONCLUSION: In this large aggregate institutional dataset, intravenous analgesia was the predominant strategy. Unadjusted comparisons suggest a higher rate of inadequate analgesia in the intravenous group relative to the epidural group. Future studies with patient-level data and validated adverse event capture are needed to confirm these patterns. Better resource allocation and anesthesiologist training would be beneficial to promote equitable post-CS pain management.
METHODS: This facility-based cross-sectional study used aggregate institutional data submitted by department heads through the Hubei Anesthesia Quality Control and Service Cloud Platform. The analgesic practice (the utilization of intravenous analgesia and epidural analgesia and corresponding medication regimens), their effects (the incidence of inadequate analgesia), and safety profiles (the incidence of adverse reactions) of different pain management strategy following CS were collected for analyses. The primary outcome was the incidence of inadequate analgesia, which was defined as a Visual Analog Scale (VAS) score of ≥4 points within 48 hours. Unadjusted comparisons between groups were performed using chi-square tests and Spearman's rank correlation; multivariable logistic regression was additionally applied to adjust for institutional-level covariates.
RESULTS: 36,620 CS cases were included in our analysis. Intravenous analgesia was the most common strategy (21,142 cases, 57.7%), followed by epidural analgesia (8569 cases, 23.4%). Despite its widespread use, our unadjusted comparison indicated that intravenous analgesia had significantly higher rates of inadequate pain control (VAS ≥4) than epidural analgesia (3.94% vs. 2.21%, p<0.001). Measurable disparities in analgesic practices and pain control outcomes across hospitals of different tiers and cities with different levels of economic development in Hubei Province were also observed.
CONCLUSION: In this large aggregate institutional dataset, intravenous analgesia was the predominant strategy. Unadjusted comparisons suggest a higher rate of inadequate analgesia in the intravenous group relative to the epidural group. Future studies with patient-level data and validated adverse event capture are needed to confirm these patterns. Better resource allocation and anesthesiologist training would be beneficial to promote equitable post-CS pain management.