Consensus Statement on Pain Management for Pregnant Patients with Opioid-Use Disorder from the Society for Obstetric Anesthesia and Perinatology, Society for Maternal-Fetal Medicine, and American Society of Regional Anesthesia and Pain Medicine.

IF 4.6 2区 医学 Q1 ANESTHESIOLOGY Anesthesia and analgesia Pub Date : 2024-11-06 DOI:10.1213/ANE.0000000000007237
Grace Lim, Brendan Carvalho, Ronald B George, Brian T Bateman, Chad M Brummett, Vivian H Y Ip, Ruth Landau, Sarah S Osmundson, Britany Raymond, Philippe Richebe, Mieke Soens, Mishka Terplan
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Abstract

Pain management in pregnant and postpartum people with an opioid-use disorder (OUD) requires a balance between risks associated with opioid tolerance, including withdrawal or return to opioid use, considerations around social needs of the maternal-infant dyad, and the provision of adequate pain relief for the birth episode that is often characterized as the worst pain a person will experience in their lifetime. This multidisciplinary consensus statement between the Society for Obstetric Anesthesia and Perinatology (SOAP), Society for Maternal-Fetal Medicine (SMFM), and American Society of Regional Anesthesia and Pain Medicine (ASRA) provides a framework for pain management in obstetric patients with OUD. The purpose of this consensus statement is to provide practical and evidence-based recommendations and is targeted to health care providers in obstetrics and anesthesiology. The statement is focused on prenatal optimization of pain management, labor analgesia, and postvaginal delivery pain management, and postcesarean delivery pain management. Topics include a discussion of nonpharmacologic and pharmacologic options for pain management, medication management for OUD (eg, buprenorphine, methadone), considerations regarding urine drug testing, and other social aspects of care for maternal-infant dyads, as well as a review of current practices. The authors provide evidence-based recommendations to optimize pain management while reducing risks and complications associated with OUD in the peripartum period. Ultimately, this multidisciplinary consensus statement provides practical and concise clinical guidance to optimize pain management for people with OUD in the context of pregnancy to improve maternal and perinatal outcomes.

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产科麻醉与围产医学会、母胎医学会和美国区域麻醉与疼痛医学会关于阿片类药物使用障碍的妊娠患者疼痛管理的共识声明。
妊娠期和产后阿片类药物滥用症(OUD)患者的疼痛管理需要在阿片类药物耐受性相关风险(包括戒断或重新使用阿片类药物)、母婴二人组的社会需求考虑因素以及为通常被描述为患者一生中经历的最严重疼痛的分娩过程提供充分止痛之间取得平衡。产科麻醉与围产医学会 (SOAP)、母胎医学会 (SMFM) 和美国区域麻醉与疼痛医学会 (ASRA) 的这份多学科共识声明为患有 OUD 的产科患者的疼痛管理提供了一个框架。本共识声明旨在提供实用的循证建议,其目标受众为产科和麻醉科的医疗服务提供者。声明重点关注产前疼痛管理优化、分娩镇痛、阴道分娩后疼痛管理以及剖宫产后疼痛管理。主题包括疼痛管理的非药物和药物选择、OUD 的药物管理(如丁丙诺啡、美沙酮)、尿液药物检测的注意事项、母婴二人护理的其他社会方面,以及对当前实践的回顾。作者提供了循证建议,以优化疼痛管理,同时降低围产期 OUD 相关风险和并发症。最终,这份多学科共识声明为优化妊娠期 OUD 患者的疼痛管理提供了实用而简明的临床指导,从而改善孕产妇和围产期的预后。
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来源期刊
Anesthesia and analgesia
Anesthesia and analgesia 医学-麻醉学
CiteScore
9.90
自引率
7.00%
发文量
817
审稿时长
2 months
期刊介绍: Anesthesia & Analgesia exists for the benefit of patients under the care of health care professionals engaged in the disciplines broadly related to anesthesiology, perioperative medicine, critical care medicine, and pain medicine. The Journal furthers the care of these patients by reporting the fundamental advances in the science of these clinical disciplines and by documenting the clinical, laboratory, and administrative advances that guide therapy. Anesthesia & Analgesia seeks a balance between definitive clinical and management investigations and outstanding basic scientific reports. The Journal welcomes original manuscripts containing rigorous design and analysis, even if unusual in their approach.
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