ورقة علمية / Research Paper

Objectives Primary Objective: • To determine whether preoperative anxiety predicts postoperative pain intensity in women undergoing elective cesarean section under spinal anesthesia. Secondary Objectives: 1. To assess the prevalence of high, moderate, and low preoperative anxiety among women undergoing elective CS. 2. To evaluate the association between preoperative anxiety and postoperative analgesic consumption (diclofenac, ibuprofen, paracetamol). 3. To explore the influence of obstetric factors, including previous CS, on postoperative pain levels. 4. To provide evidence for implementing anxiety-reduction interventions to improve postoperative outcomes. Methods Study Design and Setting This study will be conducted in the Northern state Sudan. The study will assess the association between preoperative anxiety and postoperative pain in women undergoing elective cesarean section under spinal anesthesia. Participants A total of 370 women scheduled for elective CS . Inclusion Criteria: • Age ≥18 years and able to give informed consent • Undergoing elective CS under spinal anesthesia • No prior psychiatric or neurological disorders Exclusion Criteria: • Patients receiving general anesthesia • Incomplete data or medical records Data Collection Data will be obtained using a structured data collection sheet including: 1. Sociodemographic characteristics: age, place of residence 2. Obstetric history: parity, history of previous CS 3. Preoperative anxiety assessment: VAS-A (0–10 scale, 0 = no anxiety, 10 = worst anxiety) 4. Postoperative pain assessment: NRS-P (0–10) at 2, 4, 6, and 12 hours post-surgery 5. Postoperative analgesic use: diclofenac, ibuprofen, and paracetamol extracted from medical records Statistical Analysis • Analysis will be conducted using Jamovi software version 2.6.26.

All participants will receive clear information about the study, including its purpose, procedures, potential risks and benefits, and their right to withdraw at any time without affecting care. Consent will be obtained verbally or in writing, depending on literacy levels.

• Early identification of women with high preoperative anxiety, allowing targeted interventions (e.g., counseling, relaxation techniques) to reduce anxiety before surgery. • Improved postoperative pain management through better understanding of how preoperative anxiety influences analgesic requirements. • Enhanced maternal comfort, faster recovery, and potentially shorter hospital stays by optimizing pain control and psychological support.