Acute Pain Burden and Opioid Dose Requirements after Cesarean Delivery in Parturients with Preexisting Chronic Back Pain and Migraine
Introduction. Preexisting chronic pain has been reported to be a consistent risk factor for severe acute postoperative pain. However, each specific chronic pain condition has unique pathophysiology, and it is possible that the effect of each condition on postoperative pain is different. Methods. Thi...
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2021-01-01
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| Series: | Anesthesiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/3305579 |
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| author | Ryu Komatsu Michael G. Nash Kenneth C. Ruth William Harbour Taylor M. Ziga Shane Mandalia Emily M. Dinges Davin Singh Hani El-Omrani Joseph Reno Brendan Carvalho Laurent A. Bollag |
| author_facet | Ryu Komatsu Michael G. Nash Kenneth C. Ruth William Harbour Taylor M. Ziga Shane Mandalia Emily M. Dinges Davin Singh Hani El-Omrani Joseph Reno Brendan Carvalho Laurent A. Bollag |
| author_sort | Ryu Komatsu |
| collection | DOAJ |
| description | Introduction. Preexisting chronic pain has been reported to be a consistent risk factor for severe acute postoperative pain. However, each specific chronic pain condition has unique pathophysiology, and it is possible that the effect of each condition on postoperative pain is different. Methods. This is a retrospective cohort study of pregnant women with preexisting chronic pain conditions (i.e., migraine, chronic back pain, and the combination of migraine + chronic back pain), who underwent cesarean delivery. The effects of the three chronic pain conditions on time-weighted average (TWA) pain score (primary outcome) and opioid dose requirements in morphine milligram equivalents (MME) during postoperative 48 hours were compared. Results. The TWA pain score was similar in preexisting migraine and chronic back pain. Chronic back pain was associated with significantly greater opioid dose requirements than migraine (12.92 MME, 95% CI: 0.41 to 25.43, P=0.041). Preoperative opioid use (P<0.001) was associated with a greater TWA pain score. Preoperative opioid use (P<0.001), smoking (P=0.004), and lower postoperative ibuprofen dose (P=0.002) were associated with greater opioid dose requirements. Conclusions. Findings suggest women with chronic back pain and migraine do not report different postpartum pain intensities; however, women with preexisting chronic back pain required 13 MME greater opioid dose than those with migraine during 48 hours after cesarean delivery. |
| format | Article |
| id | doaj-art-7e0e3004d6cb4842bfea262414263472 |
| institution | Kabale University |
| issn | 1687-6962 1687-6970 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
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| series | Anesthesiology Research and Practice |
| spelling | doaj-art-7e0e3004d6cb4842bfea2624142634722025-02-03T07:23:29ZengWileyAnesthesiology Research and Practice1687-69621687-69702021-01-01202110.1155/2021/33055793305579Acute Pain Burden and Opioid Dose Requirements after Cesarean Delivery in Parturients with Preexisting Chronic Back Pain and MigraineRyu Komatsu0Michael G. Nash1Kenneth C. Ruth2William Harbour3Taylor M. Ziga4Shane Mandalia5Emily M. Dinges6Davin Singh7Hani El-Omrani8Joseph Reno9Brendan Carvalho10Laurent A. Bollag11Department of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USADepartment of Statistics, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USADepartment of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USADepartment of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USADepartment of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USADepartment of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USADepartment of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USADepartment of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USADepartment of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USADepartment of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USADepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 453 Quarry Road, Stanford, CA 94304, USADepartment of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USAIntroduction. Preexisting chronic pain has been reported to be a consistent risk factor for severe acute postoperative pain. However, each specific chronic pain condition has unique pathophysiology, and it is possible that the effect of each condition on postoperative pain is different. Methods. This is a retrospective cohort study of pregnant women with preexisting chronic pain conditions (i.e., migraine, chronic back pain, and the combination of migraine + chronic back pain), who underwent cesarean delivery. The effects of the three chronic pain conditions on time-weighted average (TWA) pain score (primary outcome) and opioid dose requirements in morphine milligram equivalents (MME) during postoperative 48 hours were compared. Results. The TWA pain score was similar in preexisting migraine and chronic back pain. Chronic back pain was associated with significantly greater opioid dose requirements than migraine (12.92 MME, 95% CI: 0.41 to 25.43, P=0.041). Preoperative opioid use (P<0.001) was associated with a greater TWA pain score. Preoperative opioid use (P<0.001), smoking (P=0.004), and lower postoperative ibuprofen dose (P=0.002) were associated with greater opioid dose requirements. Conclusions. Findings suggest women with chronic back pain and migraine do not report different postpartum pain intensities; however, women with preexisting chronic back pain required 13 MME greater opioid dose than those with migraine during 48 hours after cesarean delivery.http://dx.doi.org/10.1155/2021/3305579 |
| spellingShingle | Ryu Komatsu Michael G. Nash Kenneth C. Ruth William Harbour Taylor M. Ziga Shane Mandalia Emily M. Dinges Davin Singh Hani El-Omrani Joseph Reno Brendan Carvalho Laurent A. Bollag Acute Pain Burden and Opioid Dose Requirements after Cesarean Delivery in Parturients with Preexisting Chronic Back Pain and Migraine Anesthesiology Research and Practice |
| title | Acute Pain Burden and Opioid Dose Requirements after Cesarean Delivery in Parturients with Preexisting Chronic Back Pain and Migraine |
| title_full | Acute Pain Burden and Opioid Dose Requirements after Cesarean Delivery in Parturients with Preexisting Chronic Back Pain and Migraine |
| title_fullStr | Acute Pain Burden and Opioid Dose Requirements after Cesarean Delivery in Parturients with Preexisting Chronic Back Pain and Migraine |
| title_full_unstemmed | Acute Pain Burden and Opioid Dose Requirements after Cesarean Delivery in Parturients with Preexisting Chronic Back Pain and Migraine |
| title_short | Acute Pain Burden and Opioid Dose Requirements after Cesarean Delivery in Parturients with Preexisting Chronic Back Pain and Migraine |
| title_sort | acute pain burden and opioid dose requirements after cesarean delivery in parturients with preexisting chronic back pain and migraine |
| url | http://dx.doi.org/10.1155/2021/3305579 |
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