Incidence and severity of intraoperative, postoperative shoulder tip pain and associated factors in mothers who undergo cesarean section under spinal anesthesia in Tikur anbesa specialized hospital in year 2023 – 2024GC.
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Date
2024-05
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Addis Ababa University
Abstract
Background: Shoulder tip pain is a common complaint among women during and after
cesarean section delivery. In certain cases, it can be severe, debilitating and lasts for several
days. It can cause severe movement restrictions in the upper limb region. STP also seems to be
associated with increased hospitalization time and costs; it negatively affects the patient’s
physical and mental health. Pain makes breastfeeding and caring for newborns even more
difficult. There is nothing studied about STP incidence, severity and associated factors in Africa
and Ethiopia found published or documented, the aim of this study is to generate data, to create
awareness to address adequate pain management and to wipe the way for further studies.
Objectives: To determine the incidence and severity of intraoperative, postoperative shoulder tip
pain and associated factors during and after cesarean delivery.
Method and materials: institutional based, Prospective, Cross-sectional study was conducted.
The single population proportion formula was used to calculate the sample size. A total of 165
study participants were involved. Sequential non-random sampling was used to select study
participants. The data was collected by the standard questioner during the intra op period and
within 24hr post op period. The collected data were entered, cleaned, and analyzed by SPSS
version 27.0 statistical software. Descriptive results were presented by tables and figures. Bi-
variate analysis was employed to select independent variables and multivariate regression used to
measure the association between independent and dependent variate. On bi-variate analysis,
those variables with a value less than 0.25 were entered on multi-variate analysis. Finally,
variables with a p-value < 0.05 were declared as independent predictor of the outcome variables.
The model fitness test was checked by Hosmer and Lemeshow's goodness-of-fit test.
Result: Out 165 participants 44.2% experienced shoulder Tip pain either intraoperative or post
operative, 14.5% experienced intraoperative and 38.8% experienced post operative Shoulder tip
pain. Right side STP found dominant and moderate to sever type of pain scale found. Bleeding is
found to be as sole associated factor with a p value of < 0.01 with adjusted odd ratio and 95%CI
of 4.427(2.162-9.064).
Conclusion: STP is a less noticed and understood problem with high incidence rate, requires
attention and interventions. Further RCT and Multidisciplinary studies recommended.
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Keywords
Shoulder tip pain, Intraoperative, Postoperative