Home Narcotic Use After Early Discharge Following Cesarean Section [20D]

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Abstract

INTRODUCTION:

Despite the current epidemic of narcotic use/abuse among U.S. women, physicians have little objective data regarding outpatient postoperative narcotic use to help guide narcotic prescribing. Our aim was to quantify home narcotic use and pain control following cesarean section.

METHODS:

Women discharged home on postoperative day #2 following an uncomplicated term cesarean-section of a singleton fetus from May–July 2015 were enrolled. They were contacted by telephone two weeks postpartum and answered questions regarding narcotic use, pain control and pain expectations. Chart review was performed to abstract demographic, medical and peripartum data. Women who used >50 narcotic tablets, the top quartile for narcotic use, were then compared to women using ≤50 tabs.

RESULTS:

Median number of narcotic tablets used for the 99 women included in analyses was 39 (IQR 17, 50) and median prescribed was 60 (IQR 40, 65). Women in the top quartile for narcotic use versus those not had greater average infant weight (3,764 g±541 vs 3,460 g±464, P=.02), were prescribed more narcotics at discharge (62.5 [IQR 60–75] vs 60 [IQR 40, 65], P=.001), more frequently received a narcotic refill (22.7% versus 5.2%, P=.02), were still using narcotics (45.5% versus 13.0%, P=.001), and reported that their initial prescription was inadequate (27.3% versus 9.2%, P=.01). Although pain scores were higher in top quartile users, 100% rated their pain control as adequate/good.

CONCLUSION:

For women discharged on POD#2 following uncomplicated cesarean section, 75% used 50 or fewer narcotics.

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