Oxycodone as a Component of Multimodal Analgesia Post-Caesarean Section in Australia and New Zealand

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Abstract

Background:

There is a perception that oral oxycodone is becoming a popular choice for post-caesarean section analgesia. There are a lack of published data quantifying the use of oxycodone and other drugs for post-caesarean section analgesia in Australasian practice.

Aim:

To determine the use of oxycodone and other drugs for multimodal analgesia post-caesarean section and to evaluate the compatibility of these drugs with breastfeeding.

Method:

Fellows of the Australian and New Zealand College of Anaesthetists from 41 Australian and New Zealand obstetric units were invited to participate in an online survey on analgesic preference (drug, route of administration, dosing schedule) postcaesarean section and whether breastfeeding considerations influenced their choice of analgesics.

Results:

25 participants (response rate 61%) completed the survey. All of the responding obstetric units used multimodal analgesic protocols, which included oral and rectal paracetamol and non-steroidal anti-inflammatory drugs. Survey responses indicated that 50% of women in metropolitan hospitals and 95% of women in rural and regional hospitals would receive oral or rectal oxycodone post-caesarean section. Approximately, 15% of women would be asked about their intention to breastfeed. 6% of anaesthetists would modify their choice of analgesic if the patient was breastfeeding.

Conclusion:

The obstetric units preferred oral and rectal analgesics over parenteral opioids and non-steroidal antiinflammatory drugs. There was a high use of oxycodone for post-caesarean section analgesia. The analgesics chosen were largely compatible with breastfeeding.

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