Peripartum pain management in opioid dependent women

Autor(en)

Anna Höflich, Martin Langer, Reinhold Jagsch, Andjela Baewert, Bernadette Winklbaur, Gabriele Fischer, Annemarie Unger

Abstrakt

Increased pain sensitivity and the development of opioid tolerance complicate

the treatment of pain experiencedby opioid maintained pregnantwomenduring

delivery and the perinatal period. Theaim of the present

study was to investigate differences in pain management of opioid maintained

compared to nondependent 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 = 63.89 mg) and buprenorphine (mean dose at the time of

delivery = 14.05 mg) 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

dependentwomenhad a strong influence onthe 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.

Organisation(en)

Institut für Klinische und Gesundheitspsychologie

Externe Organisation(en)

Medizinische Universität Wien

Journal

European Journal of Pain

Band

Seiten

574-584

Anzahl der Seiten

ISSN

1090-3801

DOI

https://doi.org/10.1016/j.ejpain.2011.08.008

Publikationsdatum

2012

Peer-reviewed

ÖFOS 2012

303029 Suchtforschung, 501010 Klinische Psychologie

Link zum Portal

https://ucrisportal.univie.ac.at/de/publications/17697870-b7cc-4207-9ec1-00e023838857