What is the Safer Choice Than Opioids Following a C-Section

 

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More moms choosing non-opioid pain treatment post C-section

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But one thing they might not consider is what type of pain relief they will choose if they need to have a C-section. Now, new research from the University of Texas suggests that while opioids can control pain, a combination of other painkillers could offer similar relief with fewer side effects and no risk of addiction. But one thing they might not consider is what type of pain relief they will choose if they need to have a C-section.

Now, new research from the University of. Pain relief scores were slightly better in the non-opioid group, the study found. Women who took opioids were more likely to have drug-related side effects.

The most common side effects in the opioid group were sleepiness and constipation. Dinis said she hopes this study sparks interest in looking at alternative ways of managing pain after a surgery. Left and right arrows move through main tier links and expand / close menus in sub tiers.

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Is There a Safer Choice Than Opioids After a C-Section? Expectant moms often try to plan as many aspects of their upcoming delivery as they can. But one thing they might not consider is what type of pain relief they will choose if they need to have a C-section. Is there a safer choice than opioids after a C-section?

22 March 2019, by Serena Gordon, Healthday Reporter (HealthDay)—Expectant moms often try to plan as. Pain after a C-section can be controlled effectively with ibuprofen and acetaminophen, researchers said. For those who do need opioids, a lower dose can work. There’s a better way to take care of patients after C-sections to help them heal faster and manage pain without increasing their risk of long-term opioid use, researchers say. We made Tylenol and Motrin our primary pain meds after C-section.

There are very few side effects, and they’re not opioids. If patients are concerned about opioid use to treat post-surgical pain after a C-section or any other surgery, they should talk to their doctors to see if non-opioid options are available. Pain is.

List of related literature:

Well-designed studies demonstrate that the incidence of cesarean delivery in nulliparous women with epidural analgesia is similar to IV meperidine but, with superior analgesia, less maternal sedation and no need for neonatal naloxone as with meperidine.

“Drugs for Pregnant and Lactating Women E-Book” by Carl P. Weiner, Catalin Buhimschi
from Drugs for Pregnant and Lactating Women E-Book
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When parenteral or epidural opioids are used, gastric emptying is prolonged, and if general anesthesia becomes necessary, the risk for aspiration is increased.16 The opioids in common use today are meperidine, nalbuphine, butorphanol, and fentanyl.

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from Obstetrics: Normal and Problem Pregnancies E-Book
by Steven G. Gabbe, Jennifer R. Niebyl, et. al.
Elsevier Health Sciences, 2016

At other times, the neuraxial block may be inadequate for the cesarean section because either the epidural catheter is poorly positioned or insufficient time has passed for the level to increase adequately, and the anesthesia provider may administer an opioid such as fentanyl or small doses of ketamine intravenously.

“Fanaroff and Martin's Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant” by Richard J. Martin, Avroy A. Fanaroff, Michele C. Walsh
from Fanaroff and Martin’s Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant
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Elsevier Health Sciences, 2010

Epidural fentanyl and 0.5% bupivacaine for elective caesarean section.

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from Chestnut’s Obstetric Anesthesia E-Book
by David H. Chestnut, Cynthia A Wong, et. al.
Elsevier Health Sciences, 2019

Use of opioids in cesarean section The use of intrathecal or epidural opioids has been recommended for the relief of pain after cesarean section, and there have been several comparisons of intrathecal and epidural opioid use.

“Meyler's Side Effects of Analgesics and Anti-inflammatory Drugs” by Jeffrey K. Aronson
from Meyler’s Side Effects of Analgesics and Anti-inflammatory Drugs
by Jeffrey K. Aronson
Elsevier Science, 2009

Opioids (e.g., fentanyl, sufentanyl, morphine, and demerol) may be titrated in after the patient becomes stable hemodynamically and are best reserved for after the baby is delivered (to limit fetal respiratory depression).

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from Trauma: Emergency Resuscitation, Perioperative Anesthesia, Surgical Management, Volume I
by William C. Wilson, Christopher M. Grande, David B. Hoyt
CRC Press, 2007

Opioids will cross the placental barrier, and therefore should be used with caution in cesarean sections, but most effect can be reversed with the administration of antagonist such as naloxone or butorphanol.

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Use of regional anesthesia (1) avoids the risks of maternal aspiration and difficult airway associated with general anesthesia, (2) allows less anesthetic exposure to the neonate, (3) has the benefit of an awake mother, and (4) allows placement of neuraxial opioids to decrease postoperative pain.

“Basics of Anesthesia E-Book” by Ronald D. Miller, Manuel Pardo
from Basics of Anesthesia E-Book
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Elsevier Health Sciences, 2011

The very youngest patients, those from the NICU, may not tolerate volatile anesthetics, and may instead require high doses of opioids, usually fentanyl, as their agent of choice for general anesthesia.

“The Kelalis-King-Belman Textbook of Clinical Pediatric Urology” by Steven G. Docimo, Douglas Canning, Antoine Khoury, Joao Luiz Pippi Salle
from The Kelalis-King-Belman Textbook of Clinical Pediatric Urology
by Steven G. Docimo, Douglas Canning, et. al.
CRC Press, 2018

Be aware that all four of the opioids cross the placenta and that, the nearer to actual delivery you are given them, the more likely you are to notice an effect in your baby: they may be drowsy, slower to breathe, and breastfeeding may be harder to establish.

“The Positive Birth Book: A new approach to pregnancy, birth and the early weeks” by Milli Hill
from The Positive Birth Book: A new approach to pregnancy, birth and the early weeks
by Milli Hill
Pinter & Martin Ltd, 2017

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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4 comments

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  • I had a C-section last may. We are expecting our second child the first week of June by C-section. This video is very concise and didn’t miss anything that I went through last time. It was an awesome refresher for me. Thanks for putting it together

  • this is nuts. I had 3 c-sections, and it is very painful for at least 2 weeks and more. what is going to happen, they are going to put stress on someone’s heart, lungs, etc..because of the pain, and they will either damage them or cause them to die. Doctor’s need to be sued. Let’s cut them open, and say no pain meds for you.

  • Dr Beski was my obs for my pregnancy at RLH and was brilliant at caring for me. I was referred due to a previous immune issue. My birth was natural but tbh I couldn’t imagine wanting a elective c sec but I agree it’s about choice.

  • Obs want to cut you open for money if it’s not necessary. They are ok only if it’s medically necessary. Our bodies are made for natural child birth.