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Pain Management in the Opioid-Dependent Pregnant Woman

Rebecca R Safley1, Jamie Swietlikowski

  • 1Johns Hopkins University School of Nursing, Baltimore, Maryland (Ms Safley); and University of Maryland School of Medicine, Baltimore (Ms Swietlikowski).

The Journal of Perinatal & Neonatal Nursing
|April 25, 2017
PubMed

Opioid dependence is an epidemic in the United States, and the percentage of pregnant women who are opioid dependent has increased dramatically in the last decade. Pain management, already a concern for intrapartum and postpartum care, is complicated in the context of opioid dependence. This clinical review surveys the literature on pain management in opioid-dependent pregnant women to summarize current consensus and evidence to guide clinical practice. Points of consensus for pain management in opioid-dependent pregnant women include continual opioid maintenance therapy throughout the pregnancy and the postpartum period; adequate management of acute pain; the contraindication of opioid agonist-antagonists for pain management; and the need for interdisciplinary teams using a multimodal approach to provide optimal care to opioid-dependent pregnant women.

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