Background: Local anesthetic infiltration, prior to spinal anesthesia, is generally performed and results in pain upon local injection. This study was conducted to determine the correlation between; pain intensity caused by local anesthetic infiltration in cesarean section patients, and subsequent pain after 24 hours, 1 month and 3 months, postoperatively.
Materials and Methods: This prospective, observational cohort study was performed with 215 patients, scheduled for elective cesarean section. Prior to, a spinal needle insertion, 3 ml of 2% lidocaine without adrenaline was locally infiltrated via a 24G needle for 4 seconds. The patients were asked to rate their pain intensity, upon local infiltration, by using a verbal numerical rating score (VNRS) from; 0-10, whereas, 0 = no pain and 10 = the worst possible pain. During an admission, the VNRS, at rest and with movement, were evaluated at 24 hours postoperatively as well as at 1 month and 3 months, postoperatively. The patients were contacted via phone to assess their VNRS. The correlation was calculated using Spearman’s correlation. 
Results and Discussion: At 24 hours postoperatively, positive correlation was found between pain intensity of local anesthetic infiltration and acute pain intensity, both at rest (r = 0.554, p-value < 0.001) as well as with movement (r = 0.576, p-value < 0.001).  Positive correlation was also found for pain at rest (r = 0.296, p-value < 0.001) along with movement (r = 0.525, p-value < 0.001), at 1 month, postoperatively.  At 3 months, positive correlation was found for pain with movement (r = 0.299, p-value < 0.001), but there was no statistical significance for pain at rest (r = 0.076, p-value = 0.273). 
Conclusions: Statistically, significant correlations have been found between; pain intensity during local infiltration for spinal anesthesia, and both acute, chronic pain after undergoing a cesarean section. Local infiltration pain may be used as a convenient predictor for acute and chronic pain, after cesarean section.

02 / The correlation of pain intensity during local infiltration for spinal anesthesia and subsequent pain after cesarean section