Best Poster Prize Session
Pain scores versus comfort scores after caesarean section:
A Randomised Trial
ABSTRACT
Cheryl SL Chooi 1, Angela M White 2, Suyin GM Tan 3, Kate Dowling 4, Allan M Cyna5
1
Royal Adelaide Hospital, Adelaide SA 5005. Email: chooi.cs@gmail.com
Women’s and Children’s Hospital, Adelaide SA 5006. Email:white.am@hotmail.com
3
Nepean Hospital, NSW Email; dr.suyin.tan@gmail.com
4
Public Health Research Unit, Women’s and Children’s Hospital, Adelaide SA 5006 Email: kate.dowling@health.sa.gov.au
5
Women’s and Children’s Hospital, University of Adelaide, Adelaide SA 5006. allan.cyna@health.sa.gov.au
2
Objectives: Negative words to describe sensations such as, “sting” and “pain”, have been shown to increase pain. We compared
pain scores with comfort scores and investigated whether, different methods of pain assessment affect patient perceptions
and experiences post-operatively.
Methods: Following caesarean section, 300 women were randomised prior to post-anaesthesia review. Group P women were
asked to rate their pain on a 0-10 point Verbal Numerical Rating Scale (VNRS), where ‘0’ was ‘no pain’ and ‘10’ was ‘worst
pain imaginable’. Group C women were asked to rate comfort on a 0-10 point VNRS, where ‘0’was ‘no comfort’ and ‘10’ was
‘most comfortable’. All women were asked whether the caesarean wound was, bothersome, unpleasant, associated with tissue
damage and whether additional analgesia was desired. Relative risks (RR) and 95% Confidence Intervals (CI) are reported
Results: Median (IQR) VNRS Pain scores were higher than inverted Comfort scores at rest, 2 (1, 4) versus 2 (0.5, 3) P=0.001,
and movement, 6 (4, 7) versus 4 (3, 5) P<0.001. Group P women, were more likely to be bothered by their caesarean section,
had greater VAS ‘Bother’ scores, 4 (2, 6) versus 1 (0, 3) P<0.001, perceived postoperative sensations as ‘unpleasant’ (RR=3.05,
95% CI 2.20, 4.23) P<0.001 and, related to tissue damage rather than healing and recovery (RR 2.03, 95% CI 1.30, 3.18),
P=0.001. Group P women were also more likely to request additional analgesia (RR 4.33, 95% CI 1.84, 10.22) P<0.001.
Conclusions: Asking about pain and pain scores after caesarean adversely affects patients’ post-operative experiences.
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