The Relationship Between Patient-Controlled Analgesia and Postcesarean Section Pressure Ulcers: Analysis of Medical Record Data

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Abstract

Purpose:

In this study, we aim to investigate the relationship between patient-controlled analgesia (PCA) and the incidence of pressure ulcer in postcesarean section mothers.

Design:

A retrospective analysis was performed among consecutive cesarean section mothers in 2016.

Methods:

Univariate and multivariate logistic regression was used to analyze the relationship between PCA and postcesarean section pressure ulcers.

Findings:

One thousand nine hundred eighteen cesarean section mothers were included in the study. Forty-five mothers (2.3%; 95% confidence interval [CI], 1.7%-3.1%) developed stage I pressure ulcer. The pressure ulcers were cured in 2 to 5 days. Eighty percent (1,535) of mothers received PCA after cesarean section surgery. Pressure ulcer incidence was significantly higher in the PCA group compared with non-PCA groups (2.9% vs 0.0%, Fisher's exact P < .0001). Patient-controlled intravenous analgesia and patient-controlled epidural analgesia showed the same pressure ulcer risk (3.2% vs 2.6%, χ2 = 0.581, P = .446). After multivariate analysis by logistic regression, the adjusted odds ratio of PCA for pressure ulcer risk was 33.632, with a 95% CI of 25.061 to 45.134.

Conclusions:

Our results showed PCA was an independent risk factor for pressure ulcer in postcesarean section mothers. Although the pressure ulcers were all rated as stage I and can be cured in 2 to 5 days, we still recommended some pressure ulcer prevention strategy should be used for these mothers.

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