To Explore The Effect Of Pain Sensitivity Questionnaire On Guiding Intravenous Analgesia After Cesarean Section

Objectives:To investigate the effectiveness of using a pain sensitivity questionnaire to guide postoperative intravenous self-administered analgesia（PCIA）for women undergoing cesarean section.Methods:A total of 225 women were enrolled for elective cesarean section under combined lumbar-rigid anesthesia.Preoperatively,they were divided into a pain hypersensitive group（PSQ<4）and a pain hypersensitive group（PSQ>6）according to the Pain Sensitivity Questionnaire（PSQ）score.The PSQ low scoring group was randomly and blindly divided into observation group（LO group）and control group（LC group）,and the PSQ high scoring group was randomly and blindly divided into observation group（HO）and control group（HC）.Different concentrations of bupropionol tartrate were used for postoperative analgesia after PCIA(analgesics were bupropionol tartrate diluted to 100 mL with saline at 3.5μg-kg^-1-h^-1in the LC group;3.0μg-kg^-1-h^-1in the LO group;3.5μg-kg^-1-h^-1in the HC group;4.0μg-kg^-1-h^-1in the HO group).Uterine contraction pain and wound pain were assessed at 4h,8h,12h,24h and 48h postoperatively.Postoperative Ramsay sedation scores,patient medication consumption over 24 h,number of patients with a need for a clamped analgesic pump,overall postoperative satisfaction scores,time to breastfeeding,time to exhaustion,and time to early activity,and postoperative adverse events,including dizziness,drowsiness,pruritus,nausea,vomiting,and respiratory depression,were recorded and analyzed.Results:Wound pain and uterine contraction pain VAS scores at rest and activity were significantly lower in the LC group than in the LO group at 4 and 8 h postoperatively（P<0.05）.Similarly,wound pain and uterine contraction pain VAS scores at rest and activity were significantly lower in the HO group than in the HC group at 8,12,and 24 h postoperatively（P<0.05）.The Ramsay scores were significantly higher in the LC than in the LO groups at 4,8,12,24,and 48 h postoperatively（P<0.05）,but there was no statistically significant difference between the Ramsay scores in the HC group and the HO group.The overall postoperative satisfaction scores were significantly higher（P<0.05）in the LC group than in the LO and the HC groups compared to the HO group.The number of patients in the LC group with a need for a clamped analgesic pump was higher than in the LO group（P<0.05）.The difference in the number of patients in the HC and HO groups with a need for a clamped analgesic pump was not statistically significant（P>0.05）.The difference in drug consumption between patients in the LC and LO groups over 24 h was not statistically significant（P>0.05）.Patients in the HC group consumed more drugs in 24 h than the HO group（P<0.05）.There were no statistical differences in systolic blood pressure,diastolic blood pressure,heart rate,postoperative adverse effects,time to first deflation,time to first breastfeeding,or time to early activity among all patients at different time points（P>0.05）.Conclusion:The PSQ-based postoperative PCIA has better analgesic effects and can improve maternal satisfaction with postoperative analgesia,so the PSQ-based postoperative PCIA may be a better analgesic strategy and can be extended for postoperative analgesia after cesarean delivery.