1 Surgical intensive care unit, University Hospital Center PZaGa, Faculty of medicine, university of Mahajanga, Madagascar.
2 Emergency and triage department, University Hospital Center Mahavoky Atsimo, Faculty of medicine, university of Mahajanga, Madagascar.
3 Department of obstetrics and gynecology, University Hospital Center PZaGa, Faculty of medicine, university of Mahajanga, Madagascar.
4 Emergency and intensive care unit, University Hospital Center PZaGa, Faculty of medicine, university of Mahajanga, Madagascar.
World Journal of Advanced Research and Reviews, 2025, 28(03), 2407–2415
Article DOI: 10.30574/wjarr.2025.28.3.4065
Received 21 October 2025; revised on 23 December 2025; accepted on 29 December 2025
Introduction: Post-cesarean pain management remains a major challenge, as it directly influences postpartum recovery, maternal–infant bonding, and the overall childbirth experience. This study aimed to evaluate the effectiveness of combining non-pharmacological interventions with pharmacological analgesia on postoperative pain following cesarean delivery.
Methods: A prospective cohort study (1 exposed:2 non-exposed) was conducted between May and October 2025 and included 96 women undergoing cesarean delivery. The exposed group (n = 32) received standard pharmacological analgesia combined with a standardized non-pharmacological intervention protocol, whereas the non-exposed group (n = 64) received pharmacological analgesia alone. The primary outcome was postoperative pain intensity assessed at 1 hour (H1) and 2 hours (H2) after admission to the post-anesthesia care unit. Secondary outcomes included the need for rescue analgesia and maternal satisfaction assessed using a five-point Likert scale.
Results: Ninety-six women were included, including 32 in the exposed group and 64 in the non-exposed group. Baseline characteristics were generally comparable between groups, except for a slightly higher body mass index in the exposed group. Women receiving non-pharmacological interventions had a significantly lower prevalence of moderate-to-severe postoperative pain at H1 (18.8% vs. 73.4%; RR = 0.26, 95% CI: 0.12–0.53; p < 0.001) and H2 (12.5% vs. 81.3%; RR = 0.15, 95% CI: 0.06–0.39; p < 0.001). They also required rescue analgesia less frequently (12.5% vs. 43.8%; RR = 0.29, 95% CI: 0.11–0.75; p = 0.002) and reported a higher level of satisfaction with postoperative care (84.4% vs. 50.0%; RR = 1.69, 95% CI: 1.27–2.25; p = 0.001).
Conclusion: Integrating non-pharmacological interventions into a multimodal analgesic strategy significantly improves postoperative pain control and maternal satisfaction after cesarean delivery. These findings support the incorporation of non-pharmacological interventions into multimodal postoperative pain management protocols, particularly in resource-limited settings
Analgesia; Cesarean Delivery; Acute Postoperative Pain; Non-Pharmacological Interventions
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Hery Henintsoa RANDRIANIRINA, Tohaina Dolly VELONJARA, Nivoarimelina Zoly RAKOTOMALALA, Théophile MAGNI FOGUIENG, Naharisoa Giannie RASAMIMANANA and Pierana Gabriel RANDAOHARISON. Non-pharmacological interventions combined with multimodal analgesia after cesarean delivery: Effects on postoperative pain, rescue analgesic use, and maternal satisfaction. World Journal of Advanced Research and Reviews, 2025, 28(03), 2407–2415. Article DOI: https://doi.org/10.30574/wjarr.2025.28.3.4065.