Researchers presented a study at the Anesthesiology 2011 conference could help doctors predict increased risk of pain in patients having repeat C-sections. With more than one million C-sections performed each year, doctors have little preemptive knowledge of pain risk. Of the one million C-sections about 30% are repeat procedures. According to researchers, some women may show signs of increased pain risk before having a C-section.

Dr. Ruth Landau, the lead author of the study, recruited 163 women for the study. Scar mapping was used to determine scar sensitivity. The doctor also took other factors contributing to pain into consideration. All participants were asked to fill out questionnaires about current pain status and other factors that could contribute to pain. Landau believes that post C-section pain is not treated as aggressively as may be necessary.

Researchers used scar mapping to determine pain sensitivity. Small pin pricks along the previous C-section scar were used as the determining factor. Women with more sensitivity along the previous C-section scar could be at increased risk for post C-section pain during a repeat procedure. Women with less sensitivity would likely have less pain following the repeat C-section.

Using the sensitivity test results, doctors could lay out a recovery plan of action that helped reduce pain. This recovery plan would likely include pain medications tailored to the level of pain the patient is likely to experience. Some women may require stronger pain medications while others milder medications.

According to Dr. Landau, the test is simple and could easily change the healing process for women after a repeat C-section. “The fact that pain testing easily performed in a clinical setting may help identify patients with deficient pain modulation is exciting. Identifying women at risk for pain offers avenues to prevent unnecessary suffering at a time that should otherwise be a joyful and uncomplicated event.”

About 40% of the women in the study were hypersensitive to pain. However, fewer than 10% of the women in the study remembered having extreme pain after the previous C-section. Pain recall is not a sufficient tool for predicting pain after repeat C-section.

Source: Dr. Ruth Landau. American Society of Anesthesiologists. 16 October, 2011.