| Intrapartum and postpartum analgesia for women maintained on methadone during pregnancy. | |
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MedLine Citation:
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PMID: 17666599 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine whether methadone maintenance alters intrapartum or postpartum pain or medication requirements. METHODS: Sixty-eight patients treated with methadone for opiate dependence during pregnancy (vaginal n=35; cesarean n=33) were matched retrospectively to control women. Analgesic medication and pain scores (0-10) were extracted from the medical record. The primary endpoint was opiate use postpartum (oxycodone equivalents). The secondary endpoints were pain scores and intrapartum analgesia. RESULTS: There were no differences in intrapartum pain or analgesia. After vaginal birth, methadone-maintained women experienced increased pain (methadone, 2.7 [1.9-5.0]; control, 1.4 [0.5-3.0], P=.001) but no increase in opiate use ([mean+/-standard deviation] methadone 12.7+/-32.1; control 6.8+/-12.7 mg/24 h, P=.33); after cesarean delivery both pain (methadone, 5.3 [4.1-6.0]; control, 3.0 [2.2-3.9], P=.001) and opiate use (methadone, 91.6+/-51.8; control, 54.0+/-18.6 mg/24 h, P=.001) increased. CONCLUSION: Methadone-maintained women have similar analgesic needs and response during labor, but require 70% more opiate analgesic after cesarean delivery. LEVEL OF EVIDENCE: II. |
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Authors:
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Marjorie Meyer; Katherine Wagner; Anna Benvenuto; Dawn Plante; Diantha Howard |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 110 ISSN: 0029-7844 ISO Abbreviation: Obstet Gynecol Publication Date: 2007 Aug |
Date Detail:
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Created Date: 2007-08-01 Completed Date: 2007-08-30 Revised Date: 2009-10-26 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 261-6 Citation Subset: AIM; IM |
Affiliation:
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Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, and the Department of Statistics, University of Vermont College of Medicine, Burlington, VT 05401, USA. marjorie.meyer@uvm.edu |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Analgesia, Patient-Controlled Analgesics, Opioid / pharmacology* Case-Control Studies Cesarean Section Female Fentanyl / pharmacology Humans Labor Pain / drug therapy, physiopathology* Methadone / pharmacology* Pain Measurement Pain Threshold / drug effects* Pain, Postoperative / drug therapy* Postpartum Period / drug effects* Pregnancy Pregnancy Complications / drug therapy Retrospective Studies Substance-Related Disorders / complications, rehabilitation |
| Grant Support | |
ID/Acronym/Agency:
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DA 14028/DA/NIDA NIH HHS; M01 RR 00109/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Analgesics, Opioid; 437-38-7/Fentanyl; 76-99-3/Methadone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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