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Opioid prescription-use after cesarean delivery: an observational cohort study

Abstract

Objective

To evaluate current opioid prescription practices following a cesarean delivery.

Methods

Women were asked to participate in a prospective observational cohort study following a cesarean delivery. Participants were asked about their opioid use after discharge, amount leftover, subjective pain score, and satisfaction.

Results

A total of 344 women had cesarean deliveries during the study period, 242 were approached, 171 met eligibility criteria, and 109 were included in the analysis. Women in our study were predominantly African American (66.1%), high school graduates (32.1%), publicly insured (65.1%), single (55%) working mothers (68.8%). Most had been previously prescribed opioids (70.6%), of which 58.4% had a prior cesarean delivery. Only 78.8% of study participants took their opioid prescriptions, and 89.6% had an average of 17 pills leftover. The number of pills taken correlated with those prescribed in the study. Improved satisfaction in pain control with opioid and non-opioid alternatives was associated with a decrease in opioids used. Similarly, the participants’ perception of their abundant prescription quantity was associated with a decrease in prescription taken.

Conclusion

Women were prescribed excess opioids. Excess opioids accounted for 63.3% of all pills filled, a total of 1670 pills leftover, most of which were stored in an unlocked location (75.6%). Our data showed a discrepancy of pills prescribed (24) compared to those used (10), which was also perceived as enough or too many by our participants. Our study demonstrates that women would benefit from fewer opioid pills and a discussion based on their pain perception.

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Acknowledgements

This work did not receive any financial contributions.

Funding

There was no funding for this study.

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Correspondence to Katrina Mark.

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The authors report no conflict of interest.

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IRB approval/exemption was obtained through the University of Maryland School of Medicine.

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Informed consent was waived as the study was determined to be exempt.

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Avalos, C., Razzolini, G.D., Crimmins, S. et al. Opioid prescription-use after cesarean delivery: an observational cohort study. J Anesth (2021). https://doi.org/10.1007/s00540-021-02959-z

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Keywords

  • Cesarean section
  • Opiates
  • Pregnancy
  • Prescribing