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BJA Advance Access published online on July 9, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh223
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted April 4, 2004

Short Communication

Chronobiology of labour pain perception: an observational study

A. G. M. Aya 1*, N. Vialles 1, R. Mangin 1, C. Robert 1, J. M. Ferrer 1, J. Ripart 1, J. E. de La Coussaye 1

1 Division of Anesthesiology, Pain Management, Emergency and Critical Care Medicine, University Hospital, Nîmes, France

* To whom correspondence should be addressed. E-mail: guy.aya{at}chu-nimes.fr.


  Abstract

Background. Circadian variation may affect many biological and pharmacological phenomena.

Methods. To assess circadian variations in labour pain perception, 222 consecutive nulliparous women with uncomplicated pregnancy, spontaneous labour, cervical dilatation (3-5 cm), ruptured membranes and normal fetal heart rate tracings were studied. Visual analogue pain scores (VAPS) were analysed and divided into four periods: night (1:01 a.m. to 7:00 a.m.), morning (7:01 a.m. to 1:00 p.m.), afternoon (1:01 p.m. to 7:00 p.m.) and evening (7:01 p.m. to 1:00 a.m.). VAPS were also compared between daytime (morning+afternoon) and nocturnal (evening+night) periods.

Results. Daytime mean VAPS were lower than nocturnal scores [75.6 (15.1) vs 85.7 (14.1), P<0.0001]. VAPS were lower in the morning than in the afternoon, evening and night periods (ANOVA, P<0.0001).

Conclusion. Labour pain perception appears to be chronobiological, and this might be taken into account when enrolling parturients in studies designed to assess or treat labour pain.

Keywords: analgesia, obstetric; analgesic techniques, extradural; measurement techniques, visual analogue; pain, acute; pain, mechanism; pain, psychological variables; pregnancy.
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