Risk Factors of Post-Surgical Neuropathic Pain in Cesarean Section Patients: A Population-based Study

Background: We elucidated the incidence and the risk factors of post-surgical neuropathic pain (PSNP) in Cesarean section (CS) patients. Methods: Data from the Taiwan Longitudinal Health Insurance Database were analyzed. CS patients with a primary diagnosis of PSNP and had at least two ambulatory visits for PSNP treatments were identified as the PSNP subjects. CS patients without PSNP diagnosis were identified as the non-PSNP subjects. The PSNP and non-PSNP subjects were tracked from the surgery date until the end of 2008 or until loss of follow-up. Subjects with a previous history of PSNP before CS, age less than 16 or more than 50 years or missing data of anesthetic mode were excluded. Results: A total of 85 PSNP subjects and 11284 non-PSNP subjects were included. Multivariate logistic regression analyses revealed that diabetes mellitus was a risk factor of PNSP in CS patients [odds ratio (OR)=27, 95% confidence intervals (CI): 15.73 - 46.36; P＜O.OOI]. The other risk factors of PSNP in CS patients included age ≧ 35 years (OR=3.25, 95% CI: 2.01. 5.28; P＜0.001), hypertension (OR=2.48, 95% CI: 1.12 - 5.50; P=0.026), hyperlipidemia (OR=3.08, 95% CI: 1.29 - 7.39; P=0.012), chronic alcohol exposure (OR=9.61 , 95% CI: 1.53 - 60.27; P=0.016), smoking (OR=3.09, 95% CI: 1.54 - 6.21; P=0.001) and use of antidepressants (OR=7.40, 95% CI: 3.56 - 15.37; P＜0.001). Conclusions: The incidence of PSNP in CS patients was 0.74% and the risk factors included DM, age ≧ 35 years, hypertension, hyperlipidemia, chronic alcohol exposure, smoking and use of antidepressants.