Background: Opioid over-prescription after cesarean delivery (CD)
delays postoperative recovery, interferes with breastfeeding and may prompt
persistent opioid use after hospital discharge. We evaluated the effects of
implementing a multimodal stepwise analgesic regimen on opioid consumption and
pain scores after CD. Methods: This was a retrospective before-after
study. Opioid intake (expressed as morphine milligram equivalents (MME)) and pain
scores (using the 11-point numerical rating score) within 24-hours following
planned cesarean delivery under spinal anesthesia without intrathecal morphine
were compared before vs. after change in post-cesarean analgesia regimen. This
included intensified non-opioid analgesia with quadratus lumborum block and
shifting from scheduled to as-needed opioids. Mann-Whitney U test was used for
statistical comparison (p
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Original Research
Multimodal stepwise analgesia for reducing opioid consumption after cesarean delivery
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1
Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
2
Department of Anesthesiology and Intensive Therapy, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
3
Institute of Anatomy, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
4
National Institute of Public Health, 1000 Ljubljana, Slovenia
5
Department of Public Health, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
6
Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
*Correspondence: miha.lucovnik@kclj.si (Miha Lucovnik)
Clin. Exp. Obstet. Gynecol. 2021, 48(5), 1162–1166;
https://doi.org/10.31083/j.ceog4805186
Submitted: 24 April 2021 | Revised: 31 May 2021 | Accepted: 9 June 2021 | Published: 15 October 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract
Keywords
Analgesia
Cesarean delivery
Cesarean section
Opioids
Regional anesthesia
Funding
TP 20180063/University Medical Centre Ljubljana, Slovenia
Figures
Fig. 1.