Background and goals: Chronic post-surgical pain (CPCP), as defined by International Association for the Study of Pain, is pain that persists for more than 3 months after surgery and other causes are excluded.1 The caesarean section (CS) is one of the most performed surgeries currently, and it is therefore fundamental to know the incidence and impact of chronic pain after CS and how to prevent it. The aim of this study was to examine the prevalence and impact of CPSP after CS and to evaluate potential risk factors.
Materials and Methods:  
Women undergoing CS between January 2016 and June 2016 were included and interviewed by telephone for at least one year later and data from our Acute Pain Unit database was consulted. Questions were about preoperative demographic and psychological factors, intraoperative clinical factors, acute postoperative pain and pain after 3 months. Pain was evaluated with Visual Analogical Scale (VAS) from 0 to 10 and we used Brief Pain Inventory (BPI) to assess impact on daily life in women with CPSP. We considered CPSP if VAS more than 0 after 3 months.
Results and Discussion:
During the study period, 220 women underwent CS, which correspond to 28% of all deliveries and 131 answered our interview. The mean age was 33±4 years, mean body mass index 29±4kg/cm2, most had concluded high school or had a graduation and median gestational age was 38 weeks (range 30-42). Twelve percent had history of anxiety or depression, 12% had previous chronic pain, 20% had previous CS or abdominal surgery, 83% breastfed and 7% had postpartum depression. CS was emergent in 76%. Staple suture was used in 64%. Anaesthesia technique was epidural in 64%, combined in 14%, general anaesthesia in 12% and spinal in 10%. The prevalence of CPSP was 19% and there was significant association with higher gestational age (p=0.003) and superior VAS on movement one day after CS (p=0.044). Main locations of pain were incision area and lower back region. BPI results showed that CPSP did not have influence on the activities of daily living.  We also found out that 14% still complained about paraesthesia in the scar area and it had association with higher age of the pregnant (p=0.02) and lower body weight (p=0.007). We did not found associations with factors related to surgery or anaesthesia. 
Conclusion: Although prevalence of CPSC after CS was 19%, for most women included it did not have impact in their lives. Women with higher average pain intensity on movement within 24 h postoperatively have a greater risk of CPSP after CS and therefore attempts to better manage postoperative pain are needed in CPSP prevention.

11 / Chronic pain after caesarean section: prevalence, impact and risk factors