Use of Scheduled Nonopioid Analgesia to Decrease Inpatient Opioid Consumption After Scheduled Cesarean Birth

Area of Science:

• Obstetrics and Gynecology
• Anesthesiology
• Pain Management

Background:

• Postcesarean pain management was unstandardized at a community hospital.
• Opioid use and pain scores varied significantly among patients.

Purpose of the Study:

• To compare opioid consumption and pain scores in women undergoing scheduled cesarean births.
• To evaluate the impact of a new nonopioid analgesia guideline on postoperative pain management.

Main Methods:

• A quality improvement project compared pre- and post-intervention groups.
• 175 women undergoing scheduled cesarean births were included (106 pre, 69 post).
• The post-intervention group received scheduled oral acetaminophen, IV ketorolac, and oral ibuprofen, with oral oxycodone for breakthrough pain.

Main Results:

• Mean opioid consumption decreased from 21.15 to 3.91 mg morphine equivalent (p < .001).
• Opioid use beyond the initial dose dropped from 47.2% to 84.1% (p < .001).
• Mean pain scores decreased from 2.49 to 1.62 (p < .001), with highest reported pain scores also decreasing.

Conclusions:

• Scheduled nonopioid multimodal analgesia is effective for postoperative pain management after cesarean birth.
• This strategy significantly reduces subjective pain and overall opioid consumption.
• The guideline supports improved pain control and reduced opioid reliance in surgical birth patients.