Document Detail


Peripartum pain management in opioid dependent women.
MedLine Citation:
PMID:  21930404     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Increased pain sensitivity and the development of opioid tolerance complicate the treatment of pain experienced by opioid maintained pregnant women during delivery and the perinatal period. The aim of the present study was to investigate differences in pain management of opioid maintained compared to non-dependent pregnant women during delivery and the postpartum period. 40 deliveries of 37 opioid dependent women enrolled in a double-blind, double-dummy randomized controlled trial (RCT) examining the safety and efficacy of methadone (mean dose at the time of delivery=63.89mg) and buprenorphine (mean dose at the time of delivery=14.05mg) during pregnancy were analyzed and participants were matched to a non-dependent comparison group of 80 pregnant women. Differences in pain management (opioid and non-opioid analgesic medication) during delivery and perinatal period were analyzed. Following cesarean delivery opioid maintained women received significantly less opioid analgesics (day of delivery p=0.038; day 1: p=0.02), NSAIDs were administered more frequently to opioid dependent patients than to the comparison group during cesarean section and on the third day postpartum. Significantly higher nicotine consumption in the group of opioid dependent women had a strong influence on the retrieved results, and might be considered as an independent factor of altered pain experience. Differences in pain treatment became evident when comparing opioid maintained women to healthy controls. These differences might be based on psychosocial consequences of opioid addiction along with the lack of an interdisciplinary consensus on pain treatment protocols for opioid dependent patients.
Authors:
Anna S Höflich; Martin Langer; Reinhold Jagsch; Andjela Bäwert; Bernadette Winklbaur; Gabriele Fischer; Annemarie Unger
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-17
Journal Detail:
Title:  European journal of pain (London, England)     Volume:  -     ISSN:  1532-2149     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9801774     Medline TA:  Eur J Pain     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Medical University Vienna, Department of Psychiatry and Psychotherapy, Währinger Gürtel 18-20, 1090 Vienna, Austria.
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