• Thais Orrico de Brito Cançado, Maruan Omais, Hazem Adel Ashmawi, and Marcelo Luis Abramides Torres.
• Faculdade de Medicina, Universidade de São Paulo, (USP), Brazil. thaiscancado@terra.com.br
• Rev Bras Anestesiol. 2012 Nov 1;62(6):762-74.

Background And ObjectivesBrazil ranks second among countries with the highest rates of cesarean section in the world. Little is known about the future consequences of this procedure on maternal health. This study investigated the influence of anesthetic/surgical technique and postoperative analgesia on the onset of chronic pain after three months of cesarean section.MethodThis is a prospective randomized study of 443 patients undergoing cesarean section (elective and emergency), with different doses of hyperbaric bupivacaine 0.5% and opioids in spinal anesthesia. Patients were alocated into five groups as follow: G1 received hyperbaric bupivacaine (8 mg), sufentanil (2.5 μg), and morphine (100 μg); G2 received hyperbaric bupivacaine (10 mg), sufentanil (2.5 μg), and morphine (100 μg); G3 received hyperbaric bupivacaine (12.5 mg) and morphine (100 μg); G4 received hyperbaric bupivacaine (15 mg) and morphine (100 μg); G5 received hyperbaric bupivacaine (12.5 mg) and morphine (100 μg), without perioperative anti-inflammatory. Pain at rest and in movement were evaluated in the immediate postoperative period. Phone contact was made after three months of surgery for identification of patients with chronic pain.ResultsThe incidence of chronic pain in the groups was G1=20%; G2=13%; G3=7.1%; G4=2.2%, and G5=20.3%. Patients who reported higher pain scores in the postoperative period had a higher incidence of chronic pain (p<0.05).ConclusionThe incidence of chronic pain decreases with higher doses of local anesthetics and use of anti-inflammatory drugs. The higher pain scores in the postoperative period were associated with chronic pain development after three months of cesarean section.Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

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