Evidence-based approach to treating post-delivery pain in new moms during opioid crisis

November 14, 2017, American Society of Anesthesiologists

Women who undergo vaginal delivery often do not require opioids to manage pain after hospital discharge, concludes a study published in Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA). In addition, the quantity of opioids prescribed to women after cesarean delivery can be less than currently prescribed. The study looked at the times it takes for pain to resolve, stopping the use of opioids and other pain medications, and functional recovery following childbirth in healthy, first-time mothers.

"Most available information about women's after delivery is limited to the 48 to 72 hours women are in the hospital after giving birth," said lead study author Ryu Komatsu, M.D., a physician anesthesiologist at Stanford University, California. "There are little data about what happens during the postpartum period, between the time a woman is discharged from the hospital and six weeks later when she visits her OB/GYN. We wanted to see how long it takes for the pain to resolve as well as when women regain their daily functionality."

To help provide expectations regarding pain, recovery and pain medication use for new mothers during the , researchers studied 213 women who had given birth for the first-time. Starting the day after delivery, the women were contacted daily, either in person during their hospitalization or by telephone after discharge. They were asked about the pain on a scale of 0 to 10, painkiller use, and .

Among women who had a vaginal delivery, 31 percent of patients required opioids for a short period in the hospital, with a median time to stopping use of less than one day. Less than 10 percent required opioids after hospitalization. The median time for stopping all painkillers (including nonsteroidal anti-inflammatories and acetaminophen) was 11 days. Pain resolved in a median of 14 days.

Among women who had a cesarean delivery, 91 percent required opioids for pain management, with a median time to stopping the opioids of nine days. The median time for stopping all painkillers was 16 days, and pain resolved in a median of 21 days.

It took 47 days and 57 days for 95 percent of women undergoing vaginal delivery and cesarean delivery, respectively, to recover their normal level of daily functioning.

"Based on our observations, routine opioid prescription for new moms after is not recommended, and prescription of opioids at discharge from the hospital for undergoing cesarean delivery should be limited," the researchers concluded. "However, it is important to keep in mind that we did find significant variability in pain for both types of delivery and if opioid requirements exceed the expectations of our findings, the patients should be individually evaluated by their providers."

Explore further: Opioids following cesarean delivery may be over-prescribed

Related Stories

Opioids following cesarean delivery may be over-prescribed

June 8, 2017
Cesarean delivery is the most common inpatient surgical procedure in the United States, with 1.4 million c-sections performed each year. Opioids, most commonly oxycodone, are the standard pain medications prescribed to women ...

Patients use about half of opioids prescribed after hysterectomy

November 10, 2017
(HealthDay)—Gynecologists prescribe about twice the amount of opioids than patients use after hysterectomy for benign, nonobstetric indications, according to a study published online Nov. 7 in Obstetrics & Gynecology.

Length of incision may affect pain after cesarean delivery

October 22, 2017
Both short and long surgical incisions for cesarean births are associated with increased pain after delivery, suggests a study being presented at the ANESTHESIOLOGY 2017 annual meeting. Based on the findings, the authors ...

Twelve percent of women fill opioid rx after vaginal delivery

February 10, 2017
(HealthDay)—Twelve percent of women fill an outpatient opioid prescription within five days of vaginal delivery, according to a study published in the March issue of Obstetrics & Gynecology.

Drugstore pain pills as effective as opioids in ER patients

November 7, 2017
Emergency rooms are where many patients are first introduced to powerful opioid painkillers, but what if doctors offered over-the-counter pills instead? A new study tested that approach on patients with broken bones and sprains ...

Hip and knee replacement patients using fewer opioids to manage pain after surgery

October 22, 2017
Opioid use in patients recovering from hip and knee replacement decreased by one-third between 2006 and 2014, reflecting success in efforts to promote a multimodal approach to pain management (using a variety of methods to ...

Recommended for you

Health insurance plans may be fueling opioid epidemic

June 22, 2018
Health care insurers including Medicare, Medicaid and major private insurers have not done enough to combat the opioid epidemic, suggests a study led by researchers at Johns Hopkins Bloomberg School of Public Health.

Overdose risk quintuples with opioid and benzodiazepine use

June 22, 2018
In the first 90 days of concurrent opioid and benzodiazepine use, the risk of opioid-related overdose increases five-fold compared to opioid-only use among Medicare recipients, according to a new study from the University ...

Discovery opens door for synthetic opioids with less addictive qualities

June 1, 2018
Making opioids from sugar instead of from field grown opium poppies has the potential to solve many of the problems associated with manufacturing strong pain killers.

US doctors prescribing fewer opioid painkillers: report

May 31, 2018
US doctors reduced the number of prescriptions for opioid painkillers last year, continuing a five-year trend, in an effort to reverse a deadly drug abuse epidemic, a report released Thursday said.

Researchers publish study on new therapy to treat opioid use disorder

May 22, 2018
Better delivery of medications to treat opioid use disorder (OUD) is key to addressing the opioid crisis and helping the 2.6 million Americans affected by the disease.

Could nonprofit drug companies cut sky-high prices?

May 17, 2018
(HealthDay)—Generic prescription drugs should be cheap, but prices for some have soared in the United States in recent years. Now a group of U.S. hospitals thinks it has a solution: a nonprofit drug maker.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.