Nav: Home

Evidence-based approach to treating post-delivery pain in new moms during opioid crisis

November 14, 2017

CHICAGO - Women who undergo vaginal delivery often do not require opioids to manage pain after hospital discharge, concludes a study published in Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA). In addition, the quantity of opioids prescribed to women after cesarean delivery can be less than currently prescribed. The study looked at the times it takes for pain to resolve, stopping the use of opioids and other pain medications, and functional recovery following childbirth in healthy, first-time mothers.

"Most available information about women's pain after delivery is limited to the 48 to 72 hours women are in the hospital after giving birth," said lead study author Ryu Komatsu, M.D., a physician anesthesiologist at Stanford University, California. "There are little data about what happens during the postpartum period, between the time a woman is discharged from the hospital and six weeks later when she visits her OB/GYN. We wanted to see how long it takes for the pain to resolve as well as when women regain their daily functionality."

To help provide expectations regarding pain, recovery and pain medication use for new mothers during the postpartum period, researchers studied 213 women who had given birth for the first-time. Starting the day after delivery, the women were contacted daily, either in person during their hospitalization or by telephone after discharge. They were asked about the pain on a scale of 0 to 10, painkiller use, and functional recovery.

Among women who had a vaginal delivery, 31 percent of patients required opioids for a short period in the hospital, with a median time to stopping opioid use of less than one day. Less than 10 percent required opioids after hospitalization. The median time for stopping all painkillers (including nonsteroidal anti-inflammatories and acetaminophen) was 11 days. Pain resolved in a median of 14 days.

Among women who had a cesarean delivery, 91 percent required opioids for pain management, with a median time to stopping the opioids of nine days. The median time for stopping all painkillers was 16 days, and pain resolved in a median of 21 days.

It took 47 days and 57 days for 95 percent of women undergoing vaginal delivery and cesarean delivery, respectively, to recover their normal level of daily functioning.

"Based on our observations, routine opioid prescription for new moms after vaginal delivery is not recommended, and prescription of opioids at discharge from the hospital for women undergoing cesarean delivery should be limited," the researchers concluded. "However, it is important to keep in mind that we did find significant variability in pain for both types of delivery and if opioid requirements exceed the expectations of our findings, the patients should be individually evaluated by their providers."
-end-
THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS

Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Join the ANESTHESIOLOGY® social conversation today. Like ASA on Facebook; follow ASALifeline on Twitter.

American Society of Anesthesiologists

Related Pain Articles:

Spinal manipulation treatment for low back pain associated with modest improvement in pain, function
Among patients with acute low back pain, spinal manipulation therapy was associated with modest improvements in pain and function at up to six weeks, with temporary minor musculoskeletal harms, according to a study published by JAMA.
Pain in the neck
Researchers led by University of Utah bioengineering assistant professor Robby Bowles have discovered a way to curb chronic pain by modulating genes that reduce tissue- and cell-damaging inflammation.
Can staying active help to prevent chronic pain? Physical activity affects pain modulation in older adults
Older adults with higher levels of physical activity have pain modulation patterns that might help lower their risk of developing chronic pain, reports a study in PAIN®, the official publication of the International Association for the Study of Pain (IASP).
Is back pain killing us?
Older people who suffer from back pain have a 13 per cent increased risk of dying from any cause, University of Sydney research has found.
Improving pain care through implementation of the Stepped Care Model for Pain Management
A new study published in the Journal of Pain Research provides evidence that implementation of a Stepped Care Model for Pain Management has the potential to more adequately treat chronic pain.
Surgery for back pain reduces problems with sex life-related pain
For patients with degenerative spinal disease, surgery is more effective in reducing pain that interferes with sexual activity, compared to nonsurgical treatment, reports a study in the Nov.
'Pain paradox' discovery provides route to new pain control drugs
A natural substance known to activate pain in the central nervous system has been found to have the opposite effect in other parts of the body, potentially paving the way to new methods of pain control.
Treating pain without feeding addiction: Study shows promise of non-drug pain management
A new study shows the potential for patients who have both addiction issues and chronic pain to get relief from an approach that combines behavioral therapy and social support to help them manage their pain without painkillers that carry an addiction risk.
Neuropathic pain unmasks subliminal excitation in pain processing circuits
Research by Steven Prescott, at Toronto's Hospital for Sick Children, sheds new light on the mechanism underlying the establishment of neuropathic pain.
The anatomy of pain
Emotions consist of general components that are also elicited by similar impressions and specific components.

Related Pain Reading:

Pain Free: A Revolutionary Method for Stopping Chronic Pain
by Pete Egoscue (Author), Roger Gittines (Author)

Starting today, you don't have to live in pain.

That is the revolutionary message of this breakthrough system for eliminating chronic pain without drugs, surgery, or expensive physical therapy. Developed by Pete Egoscue, a nationally renowned physiologist and sports injury consultant to some of today's top athletes, the Egoscue Method has an astounding 95 percent success rate. The key is a series of gentle exercises and carefully constructed stretches called E-cises. Inside you'll find detailed photographs and step-by-step instructions for dozens of e-cizes specifically designed to... View Details


Healing Back Pain: The Mind-Body Connection
by John E. Sarno (Author)

Dr. John E. Sarno is a medical pioneer whose program has helped thousands upon thousands of people overcome their back conditions--without or drugs or dangerous surgery. Now, using his groundbreaking research into TMS (Tension Myositis Syndrome), Dr. Sarno goes one step further: after identifying stress and other psychological factors in back pain, he demonstrates how many of his patients have gone on to heal themselves without exercise or other physical therapy. Find out: Why self-motivated and successful people are prone to TMS; How anxiety and repressed anger trigger muscle spasms; How... View Details


The Problem of Pain
by C. S. Lewis (Author)

In The Problem of Pain, C.S. Lewis, one of the most renowned Christian authors and thinkers, examines a universally applicable question within the human condition: “If God is good and all-powerful, why does he allow his creatures to suffer pain?” With his signature wealth of compassion and insight, C.S. Lewis offers answers to these crucial questions and shares his hope and wisdom to help heal a world hungering for a true understanding of human nature.

View Details


Gift of Pain, The
by Paul Brand (Author), Philip Yancey (Author)

A WORLD WITHOUT PAIN?Can such a place exist? It not only can―it does. But it’s no utopia. It’s a colony for leprosy patients: a world where people literally feel no pain, and reap horrifying consequences.His work with leprosy patients in India and the United States convinced Dr. Paul Brand that pain truly is one of God’s great gifts to us. In this inspiring story of his fifty-year career as a healer, Dr. Brand probes the mystery of pain and reveals its importance. As an indicator that lets us know something is wrong, pain has a value that becomes clearest in its absence.The Gift of... View Details


Pain: The Science of Suffering (Maps of the Mind)
by Patrick Wall (Author)

Pain is one of medicine's greatest mysteries. When farmer John Mitson caught his hand in a baler, he cut off his trapped hand and carried it to a neighbor. "Sheer survival and logic" was how he described it. "And strangely, I didn't feel any pain." How can this be? We're taught that pain is a warning message to be heeded at all costs, yet it can switch off in the most agonizing circumstances or switch on for no apparent reason. Many scientists, philosophers, and laypeople imagine pain to operate like a rigid, simple signaling system, as if a particular injury generates a fixed amount of pain... View Details


The Body in Pain: The Making and Unmaking of the World
by Elaine Scarry (Author)

Part philosophical meditation, part cultural critique, The Body in Pain is a profoundly original study that has already stirred excitement in a wide range of intellectual circles. The book is an analysis of physical suffering and its relation to the numerous vocabularies and cultural forces--literary, political, philosophical, medical, religious--that confront it.

Elaine Scarry bases her study on a wide range of sources: literature and art, medical case histories, documents on torture compiled by Amnesty International, legal transcripts of personal injury trials, and military... View Details


Explain Pain (8311)
by David Butler (Author)

Explain Pain is a proven stayer among health texts. With great clarity and quirky images, it answers common questions asked by pain sufferers, such as "Why am I in pain?", "Why has it spread?" and "What can I do to help?"

Explain Pain gives new and immediate hope to pain sufferers and their family and friends. It describes the complexities of the central nervous system for chronic pain patients in everyday language. Studies now show that understanding more about why things hurt can help patients go about their daily lives. This book aims to empower clinicians and pain sufferers to... View Details


8 Steps to a Pain-Free Back: Natural Posture Solutions for Pain in the Back, Neck, Shoulder, Hip, Knee, and Foot
by Esther Gokhale (Author), Susan Adams (Editor)

Nearly 90% of American adults suffer from back pain, and the number continues to climb. Why does this condition affect so many people in the industrialized world, while in some countries only 5% of adults report back pain? In a quest to find the root cause of back pain, Esther Gokhale studied at the Aplomb Institute in Paris and traveled to parts of the world where back pain is virtually unknown. Her research took her to remote Burkina Faso, rural Portugal, and fishing villages in Brazil.

What she learned in each of these places has changed the lives of thousands of people.... View Details


The Nectar of Pain
by Najwa Zebian (Author)

The Nectar of Pain is a collection of poetry and prose that the pain of love and loss gave birth to. This collection of poetry that I share from mysoul with you follows what most of us go through after experiencing a painful heartbreak. Overall, there may be stages of healing, but cleansing yourself of the pain day by day, hour by hour and second by second is the real struggle. Healing is not as predictable as we would like it to be. We may take ten steps forward one day, and take twenty back the next day. As we walk this journey together, some poems will address you. Some will address the... View Details


Cannabis for Chronic Pain: A Proven Prescription for Using Marijuana to Relieve Your Pain and Heal Your Life
by Dr. Rav Ivker (Author)

The first authoritative and comprehensive guide for treating chronic pain with medical marijuana from a holistic family physician who has treated more than six thousand chronic pain patients with cannabis.

While the number of patients using medical marijuana increases every year, misconceptions about cannabis and whether it’s harmful or dangerous still exist. In Cannabis for Chronic Pain, Dr. Rav explains the potential of marijuana’s capacity for healing anyone afflicted with chronic pain. Medical marijuana is a safe, non-addictive alternative to dangerous opiate pain... View Details

Best Science Podcasts 2017

We have hand picked the best science podcasts for 2017. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Simple Solutions
Sometimes, the best solutions to complex problems are simple. But simple doesn't always mean easy. This hour, TED speakers describe the innovation and hard work that goes into achieving simplicity. Guests include designer Mileha Soneji, chef Sam Kass, sleep researcher Wendy Troxel, public health advocate Myriam Sidibe, and engineer Amos Winter.
Now Playing: Science for the People

#448 Pavlov (Rebroadcast)
This week, we're learning about the life and work of a groundbreaking physiologist whose work on learning and instinct is familiar worldwide, and almost universally misunderstood. We'll spend the hour with Daniel Todes, Ph.D, Professor of History of Medicine at The Johns Hopkins University, discussing his book "Ivan Pavlov: A Russian Life in Science."