Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjan.2012.12.001
Brazilian Journal of Anesthesiology
Scientific Article

Associação da catastrofização da dor com a incidência e a intensidade da dor perineal aguda e persistente após parto normal: estudo longitudinal tipo coorte

Association of pain catastrophizing with the incidence and severity of acute and persistent perineal pain after natural childbirth: longitudinal cohort study

Anne Danielle Santos Soares; Tânia Cursino de Menezes Couceiro; Luciana Cavalcanti Lima; Fernanda Lobo Lago Flores; Eusa Maria Belarmino Alcoforado; Roberto de Oliveira Couceiro Filho

http://dx.doi.org/10.1016/j.bjan.2012.12.001 Braz J Anesthesiol, vol.63, n4, p.317-321, 2013
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Resumo

JUSTIFICATIVA E OBJETIVOS: O parto vaginal pode resultar em dor perineal aguda e persistente pósparto. Este estudo avaliou a associação da catastrofização, fenômeno de má adaptação psicológica à dor que leva o indivíduo a magnificar a experiência dolorosa, tornando-a mais intensa, com a incidência e a intensidade da dor perineal e sua relação com o trauma perineal. MÉTODO: Estudo coorte. Realizado com gestantes em trabalho de parto. Foi aplicada a escala de pensamentos catastróficos sobre a dor durante o internamento e foram avaliados o grau da lesão perineal e a intensidade da dor perineal nas primeiras 24 horas e após oito semanas do parto por meio da escala numérica de dor. RESULTADOS: Avaliadas 55 mulheres. Sentiram dor aguda 69,1% das pacientes. Dessas, 36,3% queixaram-se de dor de moderada/forte intensidade e 14,5% de dor persistente. O escore médio de catastrofização foi de 2,15 ± 1,24. As pacientes catastrofizadoras apresentaram um risco 2,90 vezes maior (95% IC: 1,08-7,75) de apresentar dor perineal aguda e 1,31 vezes maior (95% IC: 1,05-1,64) de desenvolver dor perineal persistente. Também apresentaram um risco 2,2 vezes maior de desenvolver dor perineal aguda de maior intensidade (95% IC: 1,11-4,33). CONCLUSÕES: A incidência de dor perineal aguda e persistente após parto vaginal é alta. Gestantes catastrofizadoras apresentam maior risco de desenvolver dor perineal aguda e persistente, como também dor de maior intensidade. O trauma perineal aumentou o risco de ocorrência de dor perineal persistente.

Palavras-chave

CIRURGIA, Obstétrica, Parto Normal, Catastrofização, Períneo, DOR, Aguda, TÉCNICAS DE MEDIÇÃO, Dor

Abstract

BACKGROUND AND OBJECTIVES: Vaginal birth delivery may result in acute and persistent perineal pain postpartum. This study evaluated the association between catastrophizing, a phenomenon of poor psychological adjustment to pain leading the individual to magnify the painful experience making it more intense, and the incidence and severity of perineal pain and its relationship to perineal trauma. METHOD: Cohort study conducted with pregnant women in labor. We used the pain catastrophizing scale during hospitalization and assessed the degree of perineal lesion and pain severity in the first 24 hours and after 8 weeks of delivery using a numerical pain scale. RESULTS: We evaluated 55 women, with acute pain reported by 69.1%, moderate/severe pain by 36.3%, and persistent pain by 14.5%. Catastrophizing mean score was 2.15 ± 1.24. Catastrophizing patients showed a 2.90 relative risk (RR) for perineal pain (95% CI: 1.08-7.75) and RR: 1.31 for developing persistent perineal pain (95% CI: 1.05-1.64). They also showed a RR: 2.2 for developing acute and severe perineal pain (95% CI: 1.11-4.33). CONCLUSIONS: The incidence of acute and persistent perineal pain after vaginal delivery is high. Catastrophizing pregnant women are at increased risk for developing acute and persistent perineal pain, as well as severe pain. Perineal trauma increased the risk of persistent perineal pain.

Keywords

Acute Pain, Catastrophization, Natural Childbirth, Obstetric Surgical, Procedures, Pain Measurement, Perineum

References

Eisenach JC, Pan PH, Smiley R, Lavand'homme P. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain. 2008;140:87-94.

Borders N. After the afterbirth: a critical review of postpartum health relative to method of delivery. J Midwifery Womens Health. 2006;51:242-248.

Olofsson N. Labor pain and the treatment. 2003.

Flink IK, Mroczek MZ, Sullivan MJL. Pain in childbirth and postpartum recovery: The role of catastrophizing. Eur J Pain. 2009;13:312-316.

Andrews V, Thakar R, Sultan AH. Evaluation of postpartum perineal pain and dyspareunia: A prospective study. Eur J Obstet Gynecol Reprod Biol. 2008;137:152-156.

Leeman L, Fullilove AM, Borders N. Postpartum perineal pain in a low episiotomy setting: association with severity of genital trauma, labor care, and birth variables. Birth. 2009;36:283-288.

Macarthur AJ, Macarthur C. Incidence, severity, and determinants of perineal pain after vaginal delivery: a prospective cohort study. Am J Obstet Gynecol. 2004;191:1199-1204.

Fernando RJ, Sultanb AH. Risk factors and management of obstetric perineal injury. Curr Obstet Gynaecol. 2004;14:320-326.

Lavand'homme P. Chronic pain after vaginal and cesarean delivery: a reality questioning our daily practice of obstetric anesthesia. Int J Obstet Anesth. 2010;19:1-2.

Ferber SG, Granot M, Zimmer EZ. Catastrophizing labor pain compromises later maternity adjustments. Am J Obstet Gynecol. 2005;192:826-831.

Flor H, Behle DJ, Birbaumer N. Assesment of pain: Related cognitions in chronic pain patients. Behav Res Ther. 1993;31:63-73.

Junior JS, Nicholas MK, Pereira IA. Validação da escala de pensamentos catastróficos sobre dor. Acta Fisiatr. 2008;15:31-36.

Marquié L, Duarte LR, Mariné C. How patients and physicians rate patients' pain in a French emergency department using a verbally administered numerical rating scale and a visual analog scale. Acute Pain. 2008;10:31-37.

Pitangui ACR, Sousa L, Ferreira CHJ. Mensuração e características da dor perineal em primíparas submetidas à episiotomia. Acta paul. Enferm.. 2009;22:77-82.

Eisenach JC, Pan PH, Smiley R. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain. 2008;140:87-94.

Rosenstiel AK, Keefe FJ. The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain. 1983;17:33-44.

Sullivan MJL, Bishop SR, Pivik J. The Pain Catastrophising Scale: development and validation. Psychol Assess. 1995;7:524-32.

Sullivan MJ, Thorn B, Haythornthwaite JA. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17:52-64.

Khana RS, Ahmed K, Blakeway E. Catastrophizing: a predictive factor for postoperative pain. AM J Surg. 2011;201:122-131.

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