{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T01:04:44Z","timestamp":1793235884226,"version":"4.5.0"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,11,21]],"date-time":"2014-11-21T00:00:00Z","timestamp":1416528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A large cohort study recently reported high pain scores after caesarean section (<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>). The aim of this study was to analyse how pain after <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> interferes with patients' activities and to identify possible causes of insufficient pain treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed pain scores, pain\u2010related interferences (with movement, deep breathing, mood and sleep), analgesic techniques, analgesic consumption, adverse effects and the wish to have received more analgesics during the first 24\u2009h after surgery. To better evaluate the severity of impairment by pain, the results of CS patients were compared with those of patients undergoing hysterectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> patients (<jats:italic>n<\/jats:italic>\u2009=\u2009811) were compared with patients undergoing abdominal, laparoscopic\u2010assisted vaginal or vaginal hysterectomy (<jats:italic>n<\/jats:italic>\u2009=\u20092406, from 54 hospitals). Pain intensity, wish for more analgesics and most interference outcomes were significantly worse after <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> compared with hysterectomies. <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> patients with spinal or general anaesthesia and without patient\u2010controlled analgesia (<jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content>) received significantly less opioids on the ward (62% without any opioid) compared with patients with <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content> (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Patients with <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content> reported pain\u2010related interference with movement and deep breathing between 49% and 52% compared with patients without <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content> (between 68% and 73%; <jats:italic>p<\/jats:italic>\u2010values between 0.004 and 0.013; not statistically significant after correction for multiple testing).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In daily clinical practice, pain after <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> is much higher than previously thought. Pain management was insufficient compared with patients undergoing hysterectomy. Unfavourable outcome was mainly associated with low opioid administration after <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>. Contradictory pain treatment guidelines for patients undergoing <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> and for breastfeeding mothers might contribute to reluctance of opioid administration in <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.619","type":"journal-article","created":{"date-parts":[[2014,11,21]],"date-time":"2014-11-21T06:31:47Z","timestamp":1416551507000},"page":"929-939","source":"Crossref","is-referenced-by-count":55,"title":["Quality of pain treatment after caesarean section: Results of a multicentre cohort study"],"prefix":"10.1002","volume":"19","author":[{"given":"H.","family":"Marcus","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University of Cologne  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.J.","family":"Gerbershagen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University Medical Centre Utrecht  The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.M.","family":"Peelen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University Medical Centre Utrecht  The Netherlands"},{"name":"Julius Center for Health Sciences and Primary Care University Medical Centre Utrecht  The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Aduckathil","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University of Cologne  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.H.","family":"Kappen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University Medical Centre Utrecht  The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.J.","family":"Kalkman","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University Medical Centre Utrecht  The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Meissner","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine Jena University Hospital  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.M.","family":"Stamer","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University of Bern  Switzerland"},{"name":"Department of Anaesthesiology and Pain Medicine Inselspital, University of Bern  Switzerland"},{"name":"Department of Clinical Research University of Bern  Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,11,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03021581"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2013.11.006"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep235"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2010.03.003"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767050903019643"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2008.07.011"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2007.01057.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeh258"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31828866b3"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000108"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer195"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31819ff515"},{"key":"e_1_2_9_14_1","first-page":"21","article-title":"Update on best available options in obstetrics anaesthesia: Perinatal outcomes, side effects and maternal satisfaction. 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