Pain After C-Section: Are Opioids Really Necessary?

Pain After C-Section: Are Opioids Really Necessary? (medpagetoday.com)

[MedPage Toady, 2/16/19]   Women who received non-opioid analgesia following cesarean delivery had a lower mean pain score than women who received opioids along with other pain medicine, a researcher said here.

A small randomized trial found mean pain scores lower for women in the non-opioid group versus the opioid group at 2-4 weeks postpartum, meaning opioids for pain may be inferior (12.3 vs 15.9, respectively, adjusted mean difference 4.8, 95% CI -2.1 to 11.9), reported Jenifer Dinis, MD, of McGovern Medical School at the University of Texas, Health Science Center in Houston.

In a presentation at the Society for Maternal-Fetal Medicine annual meeting, Dinis detailed how the “common practice” of prescribing 30 tablets for opioid analgesia for women who have had a C-section delivery could be contributing to the opioid crisis. For the 1.2 million C-section deliveries in the U.S., that accounts for 36 million tablets, she said, and if each patient has 10 tablets left over, that’s 12 million tablets “available for misuse.”

Given this growing crisis, Dinis and colleagues set out to examine if patients with C-section deliveries who were not given opioids for pain would have a similar pain score 2-4 weeks after delivery as patients who were given opioids.

They conducted a randomized, parallel-group equivalence trial of patients at Children’s Memorial Hermann Hospital and UT Health outpatient clinics in Houston. Participants were women, ages 18-50, with C-section deliveries who spoke English or Spanish and consented to the trial. They received an inpatient analgesia regimen at the recommendation of their primary ob/gyn, with the prescription for intervention placed in their chart and at 2-4 weeks, they were followed up in person, via phone and then emailed a link to record their pain score…………..

Read the Full Article at: Medpage Today

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Stay Strong,

Jaelin Stickels, CNM, WHNP

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