Skip to main content
Journal cover image

Personalized analgesic management for cesarean delivery.

Publication ,  Journal Article
Carvalho, B; Habib, AS
Published in: Int J Obstet Anesth
November 2019

Current pain and analgesic management strategies apply a standardized one-size-fits-all approach to women undergoing cesarean delivery. These standardized protocols do not account for significant variability in women's pain and may lead to under-treatment in patients with high analgesic needs and overtreatment, associated with increased analgesic-related side effects, in women with low analgesic needs and higher analgesic drug sensitivity. Pre-operative identification of patients at-risk of developing severe pain might allow clinicians to optimize care by offering personalized, stratified or targeted analgesic treatment protocols. Pre-operative pain prediction tools are only of moderate value in this regard. Pain reporting during local anesthetic infiltration and answering simple rating questions about anticipated pain and analgesic needs are the easiest tools to apply and show some promise for post-cesarean delivery pain prediction. Patient-driven analgesic dose and protocol selection (based on individual preferences for pain relief and for avoidance of side effects after cesarean delivery) may optimally balance individual pain needs and side effect concerns compared to standardized postoperative pain treatment protocols. Individualized or stratified post-discharge opioid prescribing practices have been shown to reduce unnecessary opioid analgesic prescriptions and consumption, so should be implemented routinely. Outcomes other than pain and analgesic use, including recovery measures and maternal satisfaction metrics, should be considered when evaluating personalized or patient-selected pain treatment protocols.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Int J Obstet Anesth

DOI

EISSN

1532-3374

Publication Date

November 2019

Volume

40

Start / End Page

91 / 100

Location

Netherlands

Related Subject Headings

  • Pregnancy
  • Precision Medicine
  • Pain, Postoperative
  • Humans
  • Female
  • Cesarean Section
  • Anesthesiology
  • Analgesia, Obstetrical
  • Adult
  • 4204 Midwifery
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Carvalho, B., & Habib, A. S. (2019). Personalized analgesic management for cesarean delivery. Int J Obstet Anesth, 40, 91–100. https://doi.org/10.1016/j.ijoa.2019.02.124
Carvalho, B., and A. S. Habib. “Personalized analgesic management for cesarean delivery.Int J Obstet Anesth 40 (November 2019): 91–100. https://doi.org/10.1016/j.ijoa.2019.02.124.
Carvalho B, Habib AS. Personalized analgesic management for cesarean delivery. Int J Obstet Anesth. 2019 Nov;40:91–100.
Carvalho, B., and A. S. Habib. “Personalized analgesic management for cesarean delivery.Int J Obstet Anesth, vol. 40, Nov. 2019, pp. 91–100. Pubmed, doi:10.1016/j.ijoa.2019.02.124.
Carvalho B, Habib AS. Personalized analgesic management for cesarean delivery. Int J Obstet Anesth. 2019 Nov;40:91–100.
Journal cover image

Published In

Int J Obstet Anesth

DOI

EISSN

1532-3374

Publication Date

November 2019

Volume

40

Start / End Page

91 / 100

Location

Netherlands

Related Subject Headings

  • Pregnancy
  • Precision Medicine
  • Pain, Postoperative
  • Humans
  • Female
  • Cesarean Section
  • Anesthesiology
  • Analgesia, Obstetrical
  • Adult
  • 4204 Midwifery