Management of Acute Postpartum Pain in Patients Maintained on Methadone or Buprenorphine During Pregnancy |
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| Authors: | Hendree E. Jones Kevin O'Grady Jennifer Dahne Rolley Johnson Laetitia Lemoine Lorriane Milio |
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| Affiliation: | 1. Johns Hopkins University, Department of Psychiatry, Baltimore, Maryland, USA;2. Department of Obstetrics and Gynecology, Baltimore, Maryland, USA;3. University of Maryland at College Park, College Park, Maryland, USA;4. Johns Hopkins University, Psychiatry, Baltimore, Maryland, USA;5. Johns Hopkins University, Obstetrics and Gynecology, Baltimore, Maryland, USA |
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| Abstract: | Background: Empirical evidence is needed to guide adequate postpartum pain relief of methadone and buprenorphine stabilized patients. Objectives: To first determine the adequacy of pain control using non-opioid and opioid medication in participants stabilized on buprenorphine or methadone before a vaginal delivery. Second, to compare the amount of non-opioid and opioid medication needed for adequate pain control for buprenorphine-and methadone-maintained patients during the immediate postpartum period. Methods: Pain control adequacy and amount of non-opioid and opioid medication needed in buprenorphine- (n = 8) and methadone-maintained (n = 10) patients over the first five days postpartum were examined. Results: Pain ratings and number of opioid medication doses decreased over time in both medication groups. While the buprenorphine and methadone groups began with similar mean daily ibuprofen (IB) doses, the buprenorphine group decreased its IB use, while the methadone group increased its IB use. Conclusions and Scientific Significance: Patients treated daily with either buprenorphine or methadone can have adequate pain control postpartum with opioid medication and IB. Pain control is dependent on the opioid-agonist medication in use at delivery, and must be individualized. |
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| Keywords: | Addiction buprenorphine methadone pain postpartum pregnancy substance abuse women |
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