Opioid Misuse After Cesarean Section

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The majority of participants said they were satisfied or very satisfied with their pain management.
The majority of participants said they were satisfied or very satisfied with their pain management.

HealthDay News — Women are routinely prescribed more opioid medications than they need after cesarean sections, creating a high risk for misuse, according to 3 studies published in Obstetrics & Gynecology.1-3

The largest of the 3 new studies involved 720 C-section patients at 6 U.S. medical centers, 85.4% of whom filled an opioid prescription when they left the hospital.1 The researchers found that women were prescribed roughly twice as many pills as they used. On average, each had 15 left over. There was no difference reported in pain scores when the authors compared women by number of pills prescribed; however, women who were prescribed more, used more.

In the second study, of 179 C-section patients studied, 165 were prescribed an opioid.2 Doses ranged from 8 to 84 pills, with nurse-midwives prescribing fewer than doctors. Three-quarters of the patients had pills left over, and only 7 women threw them away. Most (63%) kept leftovers in an unlocked cabinet, according to the study.

A third study investigated a novel approach that reduced opioid use after C-sections by 50%.3 It centered on a 10-minute meeting where a clinician spoke about postoperative pain and opioids while patients viewed a presentation on a tablet computer. Patients chose how many 5-mg oxycodone tablets to receive at discharge, up to the hospital's typical 40. The median number of pills they chose was 20. The average number of pills left over was 4. Nine out of 10 participants said they were satisfied or very satisfied with their pain management, the investigators reported.

 

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References

  1. Bateman BT, Cole NM, Maeda A, et al. Patterns of Opioid Prescription and Use After Cesarean Delivery. Obstet Gynecol. 2017. doi: 10.1097/AOG.0000000000002093
  2. Osmundson SS, Schornack LA, Grasch JL, Zuckerwise LC, Young JL, Richardson MG. Postdischarge Opioid Use After Cesarean Delivery. Obstet Gynecol. 2017. doi: 10.1097/AOG.0000000000002095
  3. Prabhu M, Mcquaid-hanson E, Hopp S, et al. A Shared Decision-Making Intervention to Guide Opioid Prescribing After Cesarean Delivery. Obstet Gynecol. 2017. doi: 10.1097/AOG.0000000000002094
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