The effects of using abdominal binder on pain intensity and mobility after cesarean section: A blind clinical trial

Year 2024, Volume: 41 Issue: 1, 34 - 39, 29.03.2024

Fatemeh Anvari , Tahereh Khalili-borujeni , Soheila Bakhtiari

Abstract

Cesarean delivery may be complicated by pain, bleeding, excessive use of painkillers, infection, or other issues. A potential non-pharmacological way to reduce post-operative pain is the use of an abdominal binder, which may also affect the mobility of patients. The present investigation was performed with the purpose of evaluating the effect of using an abdominal binder on pain intensity and mobility after caesarean section at Isfahan University of Medical Sciences. This study was a blind, two-group, one-stage parallel clinical trial with a control group. 184 pregnant women who met the inclusion criteria were randomized into two intervention and control groups with a block size of 4 and 6 and with an allocation ratio of 1:1. Each patient in the intervention group used an abdominal binder before leaving the operating room. Both groups received routine care and medication. Data collection was performed by using demographic information questionnaire, VAS scale, and recording of painkillers received. Mobility was evaluated by performing a six-minute walking test. Data analysis was done using SPSS version 24 software, independent T test and ANOVA test. A value of P < 0.05 was considered significant. 184 women candidates for cesarean section were divided in two groups of 92 people with the average age of the control group (27.7±7.3) and the intervention group (28.58±7.01). The results demonstrated that the two investigated groups were identical in terms of demographic characteristics. Based on the independent t-test, the pain intensity score of the intervention group at different times (6, 12, 18 and 24 hours after the operation) was significantly lower than the control group (P<0.05). In addition, 12 and 24 hours after the operation, the mean and standard deviation of the mobility score of the control group was significantly lower than the intervention group (P=0.038). The mean and standard deviation of the number of times receiving sedative by the intervention group was significantly lower than the control group (P<0.001). The use of abdominal binder after caesarean section was effective in reducing pain, improving mobility, and receiving sedatives in some periods of time.

Keywords

clinical trial, abdominal binder, caesarean section, pain, mobility

References

• American College of Obstetrics and Gynecology. Committee on Obestatric Practice. Committee opinion no, 555, ACOG Releases New Guidance Aimed at Making VBAC Available to more Women. . Obstetric and Gynecology. 2017(121):696-9.
• Organization WH. WHO statement on caesarean section rates. World Health Organization; 2015.
• Gregory KD, Jackson S, Korst L, Fridman M. Cesarean versus vaginal delivery: whose risks? Whose benefits? Am J Perinatol. 2012;29(1):7-18.
• Molina G, Weiser TG, Lipsitz SR, Esquivel MM, Uribe-Leitz T, Azad T, et al. Relationship Between Cesarean Delivery Rate and Maternal and Neonatal Mortality. JAMA. 2015;314(21):2263-70.
• Ghana S, Hakimi S, Mirghafourvand M, Abbasalizadeh F, Behnampour N. Randomized controlled trial of abdominal binders for postoperative pain, distress, and blood loss after cesarean delivery. Int J Gynaecol Obstet. 2017;137(3):271-6.
• Karlstrom A, Engstrom-Olofsson R, Norbergh KG, Sjoling M, Hildingsson I. Postoperative pain after cesarean birth affects breastfeeding and infant care. J Obstet Gynecol Neonatal Nurs. 2007;36(5):430-40.
• Christoffersen MW, Olsen BH, Rosenberg J, Bisgaard T. Randomized clinical trial on the postoperative use of an abdominal binder after laparoscopic umbilical and epigastric hernia repair. Hernia. 2015;19(1):147-53.
• Ganer Herman H, Ben Zvi M, Kleiner I, Tairy D, Kuper Sason L, Bar J, et al. Mobility following cesarean delivery: an observational study utilizing pedometers. J Matern Fetal Neonatal Med. 2020;33(5):774-9.
• Chankhunaphas W, Charoenkwan K. Effect of elastic abdominal binder on pain and functional recovery after caesarean delivery: a randomised controlled trial. J Obstet Gynaecol. 2020;40(4):473-8.
• Cheifetz O, Lucy SD, Overend TJ, Crowe J. The effect of abdominal support on functional outcomes in patients following major abdominal surgery: a randomized controlled trial. Physiother Can. 2010;62(3):242-53.
• Larson CM, Ratzer ER, Davis-Merritt D, Clark JR. The effect of abdominal binders on postoperative pulmonary function. Am Surg. 2009;75(2):169-71.
• Ghana S, Hakimi S, Mirghafourvand M, Abbasalizadeh F, Behnampour N. The Effects of Abdominal Binder on Wound Healing and Consumed Pain Medications After Cesarean Section: A Randomized Control Trial. Iranian Red Crescent Medical Journal. 2017;19(4).
• Gillier CM, Sparks JR, Kriner R, Anasti JN. A randomized controlled trial of abdominal binders for the management of postoperative pain and distress after cesarean delivery. Int J Gynaecol Obstet. 2016;133(2):188-91.
• Gustafson JL, Dong F, Duong J, Kuhlmann ZC. Elastic Abdominal Binders Reduce Cesarean Pain Postoperatively. Kansas Journal of Medicine. 2019;11(2):48-53.
• Azizi A, Oshvandi K, Farhahian M, Lashani A. The effect of inhalation aromatherapy with lavender essence on pain intensity and anxiety in burn patients: A clinical randomized trial. Avicenna Journal of Nursing and Midwifery Care. 2019;26(6):416-27.
• Laboratories ATSCoPSfCPF. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111-7.
• I Hassan S, Ibrahim El-Feshawy N, Hassan Ahmed A. Effect of Elastic Abdominal Binder on Post Cesarean Pain, Distress, Mobilization and Women’s Satisfaction. Egyptian Journal of Health Care. 2021;12(1):364-82.
• Rothman JP, Gunnarsson U, Bisgaard T. Abdominal binders may reduce pain and improve physical function after major abdominal surgery-a systematic review. database. 1966;2013.
• Singdaeng T, Sangkomkamhang U, Sangkomkamhang T. Using Abdominal Binder for Reducing Postoperative Wound Pain after Cesarean Delivery: A randomized controlled trial. Thai Journal of Obstetrics and Gynaecology. 2020:52-9.
• Gobbur V, Shiragur S, Jhanwar U, Tehalia M. Efficacy of tranexamic acid in reducing blood loss during lower segment caesarean section. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2014:414-7.
• Karaca I, Ozturk M, Alay I, Ince O, Karaca SY, Erdogan VS, et al. Influence of Abdominal Binder Usage after Cesarean Delivery on Postoperative Mobilization, Pain and Distress: A Randomized Controlled Trial. Eurasian J Med. 2019;51(3):214-8.
• Saeed S, Rage KA, Memon AS, Kazi S, Samo KA, Shahid S, et al. Use of Abdominal Binders after a Major Abdominal Surgery: A Randomized Controlled Trial. Cureus. 2019.