Document Detail


Intrapartum and postpartum analgesia for women maintained on methadone during pregnancy.
MedLine Citation:
PMID:  17666599     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Marjorie Meyer; Katherine Wagner; Anna Benvenuto; Dawn Plante; Diantha Howard
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  110     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-01     Completed Date:  2007-08-30     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  261-6     Citation Subset:  AIM; IM    
Affiliation:
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:
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:
DA 14028/DA/NIDA NIH HHS; M01 RR 00109/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
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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