Home opioid use following cesarean delivery: How many opioid tablets should obstetricians prescribe?

J Obstet Gynaecol Res. 2018 Apr;44(4):723-729. doi: 10.1111/jog.13579. Epub 2018 Jan 23.

Abstract

Aim: To quantify home opioid use after cesarean delivery and identify factors associated with increased opioid use.

Methods: A convenience sample of women discharged by postoperative day 2 following a term cesarean delivery of a singleton fetus from May 2015 to May 2016 were contacted 2 weeks post-partum and questioned regarding opioid use, pain control and pain expectations.

Results: Among 141 women included in the analysis, the median number of opioid tablets used was 36 (interquartile range 16-45) and the median number prescribed was 60 (interquartile range 42-65). Logistic regression identified operative time ≥59.5 min and number of opioid tablets prescribed as two factors independently associated with opioid use in the top quartile.

Conclusion: In the first 2 weeks post-partum, 75% of women used 45 or fewer opioid tablets. Operative time over 1 h and increased number of opioid tablets prescribed are factors associated with higher post-partum opioid use.

Keywords: analgesics, opioid; cesarean section; drug prescriptions; postnatal care; practice patterns, physicians’.

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use*
  • Cesarean Section / adverse effects*
  • Drug Prescriptions / standards*
  • Female
  • Humans
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / etiology
  • Patient Discharge / standards*
  • Retrospective Studies

Substances

  • Analgesics, Opioid