OBJECTIVE: To determine whether buprenorphine maintenance alters intrapartum or postpartum pain or medication requirements. METHODS: Sixty three patients treated with buprenorphine for opioid dependence during pregnancy (vaginal n = 44; cesarean n = 19) were matched retrospectively to control women. Analgesic medication and pain scores (0-10) were extracted from the medical record. Primary endpoint: opioid utilization postpartum (oxycodone equivalents). Secondary endpoints: pain scores and intrapartum analgesia. RESULTS: There were no differences in intrapartum pain or analgesia. Following vaginal birth, buprenorphine maintained women had increased pain (buprenorphine 2.7 (1.7,4.0); control 2.1 (1.2,3.0), p = 0.006) but no increase in opioid utilization (buprenorphine: 11.8 ± 24.8; control 5.4 ± 10.4 mg/24 h, p = 0.10); following cesarean delivery both pain (buprenorphine: 5.1 (4.1,6.1); control: 3.3 (2.5,4.1), p = 0.009) and opioid utilization (buprenorphine: 89.3 ± 38.0, control: 60.9 ± 13.1 mg/24 h, p = 0.004) were increased. CONCLUSION: Buprenorphine maintained women have similar intrapartum pain and analgesic needs during labor, but experience more postpartum pain and require 47% more opioid analgesic following cesarean delivery.
OBJECTIVE: To determine whether buprenorphine maintenance alters intrapartum or postpartum pain or medication requirements. METHODS: Sixty three patients treated with buprenorphine for opioid dependence during pregnancy (vaginal n = 44; cesarean n = 19) were matched retrospectively to control women. Analgesic medication and pain scores (0-10) were extracted from the medical record. Primary endpoint: opioid utilization postpartum (oxycodone equivalents). Secondary endpoints: pain scores and intrapartum analgesia. RESULTS: There were no differences in intrapartum pain or analgesia. Following vaginal birth, buprenorphine maintained women had increased pain (buprenorphine 2.7 (1.7,4.0); control 2.1 (1.2,3.0), p = 0.006) but no increase in opioid utilization (buprenorphine: 11.8 ± 24.8; control 5.4 ± 10.4 mg/24 h, p = 0.10); following cesarean delivery both pain (buprenorphine: 5.1 (4.1,6.1); control: 3.3 (2.5,4.1), p = 0.009) and opioid utilization (buprenorphine: 89.3 ± 38.0, control: 60.9 ± 13.1 mg/24 h, p = 0.004) were increased. CONCLUSION:Buprenorphine maintained women have similar intrapartum pain and analgesic needs during labor, but experience more postpartum pain and require 47% more opioid analgesic following cesarean delivery.
Authors: Hendrée E Jones; Krisanna Deppen; Mark L Hudak; Lisa Leffert; Carol McClelland; Leyla Sahin; Jacquelyn Starer; Mishka Terplan; John M Thorp; James Walsh; Andreea A Creanga Journal: Am J Obstet Gynecol Date: 2013-10-10 Impact factor: 8.661
Authors: Abigail H Rizk; Sara E Simonsen; Leissa Roberts; Lisa Taylor-Swanson; Jennifer Berkowicz Lemoine; Marcela Smid Journal: J Midwifery Womens Health Date: 2019-08-12 Impact factor: 2.388
Authors: Hendrée E Jones; Sarah H Heil; Andjela Baewert; Amelia M Arria; Karol Kaltenbach; Peter R Martin; Mara G Coyle; Peter Selby; Susan M Stine; Gabriele Fischer Journal: Addiction Date: 2012-11 Impact factor: 6.526