A Multimodal Protocol to Limit Opioid Exposure and Effectively Manage Postoperative Cesarean Birth Pain

Publication Date

3-1-2023

Document Type

Article

Publication Title

MCN: The American Journal of Maternal/Child Nursing

Volume

48

Issue

2

DOI

10.1097/NMC.0000000000000899

First Page

69

Last Page

75

Abstract

Purpose:
To evaluate the impact of implementing a multimodal plan of care in treating the pain of the postoperative cesarean birth patient that limited opioid exposure.
Study Design and Methods:
A retrospective medical record review was conducted to evaluate a pain management protocol implemented for postoperative cesarean patients before and after a practice change. Sample included term postoperative cesarean patients ≥ 37 weeks of gestation, who had spinal or epidural, were 18 years or older, gave birth to a singleton newborn, admitted to the maternal child health department, and were prescribed opioids as a postoperative pain management treatment plan. Participants (N = 150) were evaluated based on two groups: n = 75 in the preimplementation group and n = 75 in the postimplementation group.
Results:
There was a significant difference in the total oral opioid milligrams administered between the pregroup (M = 27.13) and postgroup (M = 8.43), after the practice change (p <.001). There was an increase of nonopioids administered to treat and manage postoperative cesarean pain, Motrin PO (p = <.001) and Tylenol PO (p =.002).
Clinical Implications:
Fewer milligram equivalents of morphine were administered when postoperative cesarean patients were placed on scheduled nonopioids to treat pain.

Keywords

Cesarean birth, Maternal health services, Morphine derivatives, Opioid-related disorders, Pain management, Postpartum period

Department

Nursing

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