A review of opioid use within a multimodal analgesia approach to enhance post-caesarean section pain relief

Gerrard Ferreira; Tamara Lebedevs; Stephanie Wai Khuan Teoh

doi:10.5055/jom.0921

Authors

Gerrard Ferreira, BSc (Hons), MPharm
Tamara Lebedevs, BPharm, PostGradDipPharm https://orcid.org/0000-0002-5282-4605
Stephanie Wai Khuan Teoh, BPharm (Hons), MClinPharm https://orcid.org/0000-0003-2763-1163

DOI:

https://doi.org/10.5055/jom.0921

Keywords:

pain, analgesics, opioids, multimodal analgesics, caesarean section

Abstract

Aim: This study aims to assess the application of opioids for pain control in patients following a cesarean section (CS) at a tertiary referral obstetric hospital.

Methods: A retrospective cohort audit of CSs in September 2022 was conducted. Medical records were reviewed to capture patient demographics, opioid used, and discharge medications.

Results: Medical records of 46 patients were reviewed. Of those, 46 percent (n = 21) had a non-elective lower uterine CS (NELUSCS), 43 percent (n = 20) had an elective lower uterine CS (ELUSCS), and the remainder had a nonelective classical CS (NEClassicalCS). NEClassicalCS had higher total morphine equivalent opioid use with an average of 245.7 mg, compared with 92.4 mg and 60.1 mg for NELUSCS and ELUSCS, respectively. Tramadol was the most common opioid supplied on discharge (85 percent), followed by buprenorphine (17 percent) and oxycodone/naloxone (15 percent). An average discharge medication supply of 3 days was provided.

Conclusions: NEClassicalCS procedures had higher use of opioid pain medications. All patients were initiated on opioids post-CS, with 93 percent (n = 43) discharged with at least one opioid.

Author Biographies

Gerrard Ferreira, BSc (Hons), MPharm

Pharmacist, Pharmacy Department, King Edward Memorial Hospital, Subiaco, Perth, Western Australia

Tamara Lebedevs, BPharm, PostGradDipPharm

Deputy Chief Pharmacist, Pharmacy Department, King Edward Memorial Hospital, Subiaco, Perth, Western Australia

Stephanie Wai Khuan Teoh, BPharm (Hons), MClinPharm

Deputy Chief Pharmacist, Pharmacy Department, King Edward Memorial Hospital, Subiaco, Perth, Western Australia

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