Post-Cesarean Pain Associated with Skin Incision: Vertical versus Pfannenstiel
Komsun Suwannarurk MD*, Pailin Kasemsin MD*, Densak Pongrojpaw MD*, Athita Chanthasenanont MD*, Supapen Lertvutivivat MD*, Junya Pattaraarchachai PhD**, Kornkarn Bhamarapravatana PhD***
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ** Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand *** Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Objective : The purpose of the present study was to determine post-cesarean pain in elective vertical cesarean delivery
compared to Pfannenstiel incision.
Material and Method: This was the secondary data analysis from the primary study investigating the additional post-
cesarean analgesia between ketorolac and meperidine. Parturients who had scheduled for elective cesarean delivery were
recruited. All parturients underwent elective cesarean section via spinal anesthesia. Visual analogue scale (VAS) was used to
evaluate postoperative pain at 3, 6, 12 and 24 hours. Rescue analgesia using either ketorolac or meperidine was applied when
VAS was equal or more than 6. Type of skin incision was re-analyzed and compared to other parameters.
Results : A total of 580 pregnant women were recruited in the present study. There were 276 and 304 cases in vertical and
Pfannenstiel groups, respectively. Both groups showed no statistical significant among body mass index, parity, gestation age,
estimated blood loss, birth weight, history of prior cesarean delivery and underlying diseases. In primary cesarean delivery,
VAS of vertical group was higher than Pfannenstiel group at 3, 12 and 24 hours after surgery. In repeated cesarean delivery,
VAS of Pfannenstiel group was higher than vertical group at 6 and 12 hours after operation. There was no side effect, i.e.,
nausea, vomiting, itching, respiratory depression and allergic reactions, in the present study.
Conclusion : The postoperative pain after elective cesarean delivery of both vertical and Pfannenstiel incision were comparable.
Keywords : Cesarean section, Vertical incision, Pfannenstiel incision, Pain
