Gabapentin in the Post-cesarean Pain Management of Buprenorphine Patient

Many strategies have been suggested to improve post-CD pain management in parturients on
buprenorphine. While effective pain relief can be achieved, women maintained on buprenorphine
during pregnancy have been shown to require up to 50% more opioids after CD compared to women
with opioid use disorder not on a maintenance regimen. The perioperative use of gabapentin
has been shown to reduce pain scores and opioid consumption following a variety of surgeries,
ranging from cardiac bypass to total abdominal hysterectomy. The purpose of this study is to
determine whether a perioperative course of gabapentin in parturients on buprenorphine
maintenance would improve analgesia after elective CD.

Inclusion Criteria:

- singleton, term pregnancy

- currently on buprenorphine maintenance therapy

- scheduled for elective CD under spinal anesthesia

Exclusion Criteria:

- use illicit drugs or relapse during the last trimester of pregnancy

- positive drug screen at the time of delivery

- allergies to any medications used in the study

- taking prescribed gabapentin at the time of admission for CD

- contraindications to neuraxial anesthesia or require general anesthesia for CD

- designated ASA physical status 4 or above