Pain following caesarean section (C-section) is a significant clinical problem. Pain following C-section can impair function in the immediate post-operative period (acute pain) and it can also persist for many months (chronic pain). There is evidence that high anxiety levels before surgical procedures can lead to more pain following surgery. The endogenous cannabinoid system is a signalling system in the nervous system and it plays an important role in both anxiety and pain. Endocannabinoids are the body’s own marijuana-like chemicals. The aim of the present study is to determine whether anxiety and/or endocannabinoid levels prior to C-section can predict acute pain following C-section. To-date this question has not been investigated. Women undergoing first-time elective C-section will be recruited from the Department of Obstetrics at University Hospital Galway. Anxiety levels, depression scores and pain will be assessed prior to C-section. Levels of endocannabinoids will be measured in cerebrospinal fluid (CSF) taken just prior to administration of spinal anaesthesia for surgery. The levels of anxiety, depression and endocannabinoids will be correlated with levels of pain pre- and postoperatively. The novel data arising will significantly increase our understanding of both the psychological and biochemical factors that may predispose to increased pain following C-section and will inform better management and treatment of these women into the future.
