Analgesic use after vaginal delivery in women with perineal lacerations: a retrospective cohort study

Hawkins, Nicole N; Lamon, Agnes M; Li, Yi-Ju; Grotegut, Chad A.; Habib, Ashraf S.

doi:10.1080/03007995.2020.1754185

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…Neuraxial opioids such as fentanyl and/or morphine may also be administered, although a subset of patients may prefer to avoid opioids. 51 Moreover, they may not be effective in abstinent patients managed on naltrexone. Scheduled around-The-clock acetaminophen and NSAIDs should be administered post-delivery in the absence of any contraindication.…”

Section: Subgroups Of Oudmentioning

confidence: 99%

Multimodal Acute Pain Management in the Parturient with Opioid Use Disorder: A Review

Koltenyuk,

Mrad,

Choe

et al. 2024

JPR

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The opioid epidemic in the United States has led to an increasing number of pregnant patients with opioid use disorder (OUD) presenting to obstetric units. Caring for this complex patient population requires an interdisciplinary approach involving obstetricians, anesthesiologists, addiction medicine physicians, psychiatrists, and social workers. The management of acute pain in the parturient with OUD can be challenging due to several factors, including respiratory depression, opioid tolerance, and opioid-induced hyperalgesia. Patients with a history of OUD can present in one of three categories: 1) those with untreated OUD; 2) those who are currently abstinent from opioids; 3) those being treated with medications to prevent withdrawal. A patient-centered, multimodal approach is essential for optimal peripartum pain relief and prevention of adverse maternal and neonatal outcomes. Medications for opioid use disorder (MOUD), previously referred to as medication-assisted therapy (MAT), include opioids like methadone, buprenorphine, and naltrexone. These are prescribed for pregnant patients with OUD, but appropriate dosing and administration of these medications are critical to avoid withdrawal in the mother. Non-opioid analgesics such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) can be used in a stepwise approach, and regional techniques like neuraxial anesthesia and truncal blocks offer opioid-sparing options. Other medications like ketamine, clonidine, dexmedetomidine, nitrous oxide, and gabapentinoids show promise for pain management but require further research. Overall, a comprehensive pain management strategy is essential to ensure the well-being of both the mother and the fetus in pregnant patients with OUD.

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Section: Subgroups Of Oudmentioning

confidence: 99%