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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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Autores principales: Komatsu, Ryu, Nash, Michael G., Ruth, Kenneth C., Harbour, William, Ziga, Taylor M., Mandalia, Shane, Dinges, Emily M., Singh, Davin, El-Omrani, Hani, Reno, Joseph, Carvalho, Brendan, Bollag, Laurent A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8423562/
https://www.ncbi.nlm.nih.gov/pubmed/34504525
http://dx.doi.org/10.1155/2021/3305579
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author Komatsu, Ryu
Nash, Michael G.
Ruth, Kenneth C.
Harbour, William
Ziga, Taylor M.
Mandalia, Shane
Dinges, Emily M.
Singh, Davin
El-Omrani, Hani
Reno, Joseph
Carvalho, Brendan
Bollag, Laurent A.
author_facet Komatsu, Ryu
Nash, Michael G.
Ruth, Kenneth C.
Harbour, William
Ziga, Taylor M.
Mandalia, Shane
Dinges, Emily M.
Singh, Davin
El-Omrani, Hani
Reno, Joseph
Carvalho, Brendan
Bollag, Laurent A.
author_sort Komatsu, Ryu
collection PubMed
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.
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spelling pubmed-84235622021-09-08 Acute Pain Burden and Opioid Dose Requirements after Cesarean Delivery in Parturients with Preexisting Chronic Back Pain and Migraine Komatsu, Ryu Nash, Michael G. Ruth, Kenneth C. Harbour, William Ziga, Taylor M. Mandalia, Shane Dinges, Emily M. Singh, Davin El-Omrani, Hani Reno, Joseph Carvalho, Brendan Bollag, Laurent A. Anesthesiol Res Pract Research Article 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. Hindawi 2021-08-30 /pmc/articles/PMC8423562/ /pubmed/34504525 http://dx.doi.org/10.1155/2021/3305579 Text en Copyright © 2021 Ryu Komatsu et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Komatsu, Ryu
Nash, Michael G.
Ruth, Kenneth C.
Harbour, William
Ziga, Taylor M.
Mandalia, Shane
Dinges, Emily M.
Singh, Davin
El-Omrani, Hani
Reno, Joseph
Carvalho, Brendan
Bollag, Laurent A.
Acute Pain Burden and Opioid Dose Requirements after Cesarean Delivery in Parturients with Preexisting Chronic Back Pain and Migraine
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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8423562/
https://www.ncbi.nlm.nih.gov/pubmed/34504525
http://dx.doi.org/10.1155/2021/3305579
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