Postpartum Analgesic Management of Patients at Risk for Prolonged Pain and Analgesic Use
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 12/8/2018 |
| Start Date: | September 17, 2018 |
| End Date: | March 31, 2021 |
| Contact: | Pamela Flood, MD, MA |
| Email: | pflood@stanford.edu |
| Phone: | 201-370-3933 |
Our previous work has identified the group of women at risk for prolonged pain, opioid use
and poor functional recovery after childbirth. The optimal intervention to mitigate this risk
is unknown. We propose to test an analgesic adjutant that is commonly used for post-operative
pain compared to placebo to improve post-partum recovery.
and poor functional recovery after childbirth. The optimal intervention to mitigate this risk
is unknown. We propose to test an analgesic adjutant that is commonly used for post-operative
pain compared to placebo to improve post-partum recovery.
A small percent of the large population of women who give birth have difficulty with
prolonged pain, opioid use and poor functional recovery. This may be the first opiate
exposure and significant health challenge in a young woman's life.
In our previous work, we have identified 20% who are at highest risk for prolonged pain and
delayed opioid cessation and functional recovery with usual care. Moderate to severe pain on
postpartum day 1 is a significant predictor of being in the risk group.The optimal
intervention to mitigate this risk is unknown.
We plan to test an intervention of low dose gabapentin or placebo to be escalated by a pain
medicine doctor as needed. We hypothesize that additional care of women predicted to be
higher need by virtue of their postoperative day one pain score (>6 x2) despite usual
multimodal analgesic care will lead to reduced need for opioid, less pain and more rapid
functional recovery.
prolonged pain, opioid use and poor functional recovery. This may be the first opiate
exposure and significant health challenge in a young woman's life.
In our previous work, we have identified 20% who are at highest risk for prolonged pain and
delayed opioid cessation and functional recovery with usual care. Moderate to severe pain on
postpartum day 1 is a significant predictor of being in the risk group.The optimal
intervention to mitigate this risk is unknown.
We plan to test an intervention of low dose gabapentin or placebo to be escalated by a pain
medicine doctor as needed. We hypothesize that additional care of women predicted to be
higher need by virtue of their postoperative day one pain score (>6 x2) despite usual
multimodal analgesic care will lead to reduced need for opioid, less pain and more rapid
functional recovery.
Inclusion Criteria:
- Delivery within 1 week, able to provide informed consent, English speaker
Exclusion Criteria:
- Opiate use disorder
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