Oxycodone is concentrated in human breast milk up to 72-h post-partum. Breastfed infants may receive > 10% of a therapeutic infant dose. However, maternal oxycodone intake up to 72-h post-CS poses only minimal risk to the breast-feeding infant as low volumes of breast milk are ingested during this period.
Aim: To evaluate a hospital pharmacy technician facilitated patient medication delivery system in a rural/regional hospital. Method: Pre-implementation, the medication distribution system on the study medical ward consisted of imprest and individual dispensing with medications administered to patients from medication trolleys. Post-implementation, the pharmacy technician serviced the medical ward's imprest and individual dispensing and stored in individual bedside drawers. Two missed doses audits were conducted pre-implementation and two drawer audits conducted post-implementation. Results: The ward pharmacy technician facilitated medication delivery on the medical ward and resulted in a reduction in missed doses, improvement in monitoring medication discrepancies and cost savings. Conclusion: A ward pharmacy technician service had a positive impact on medication safety (reduction in missed doses) and cost savings (by avoiding medication wastage).
Background
There is a perception that oral oxycodone is becoming a popular choice for post‐caesarean section analgesia. There are a lack of published data quantifying the use of oxycodone and other drugs for post‐caesarean section analgesia in Australasian practice.
Aim
To determine the use of oxycodone and other drugs for multimodal analgesia post‐caesarean section and to evaluate the compatibility of these drugs with breastfeeding.
Method
Fellows of the Australian and New Zealand College of Anaesthetists from 41 Australian and New Zealand obstetric units were invited to participate in an online survey on analgesic preference (drug, route of administration, dosing schedule) post‐caesarean section and whether breastfeeding considerations influenced their choice of analgesics.
Results
25 participants (response rate 61%) completed the survey. All of the responding obstetric units used multimodal analgesic protocols, which included oral and rectal paracetamol and non‐steroidal anti‐inflammatory drugs. Survey responses indicated that 50% of women in metropolitan hospitals and 95% of women in rural and regional hospitals would receive oral or rectal oxycodone post‐caesarean section. Approximately, 15% of women would be asked about their intention to breastfeed. 6% of anaesthetists would modify their choice of analgesic if the patient was breastfeeding.
Conclusion
The obstetric units preferred oral and rectal analgesics over parenteral opioids and non‐steroidal anti‐inflammatory drugs. There was a high use of oxycodone for post‐caesarean section analgesia. The analgesics chosen were largely compatible with breastfeeding.
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