Post-cesarean opioid consumption in patients on maintenance medication for opioid use disorder undergoing cesarean delivery with neuraxial anesthesia: a single-center retrospective propensity-matched cohort study (2016–2020)
Authors' conclusion
Pregnant women maintained on their pre-delivery dose of opioid agonists after cesarean delivery had opioid consumption and pain scores after undergoing cesarean delivery under neuraxial anesthesia with neuraxial morphine despite optimizing multimodal non-opioid analgesic medications than matched controls. Within both groups, the diagnosis of a mental health diagnosis was highly associated with increased MME consumption.
Study context
- Population
- Patients undergoing cesarean delivery with intrathecal morphine (median 200 μg), January 2016–December 2020matched 1:1
- Exposure
- Opioid agonist therapy vs opioid-naive matched controls
- Opioid agonist therapyn = 125
- Outcome
- Postoperative opioid consumption (MME)
- Follow-up
- 48 hours
Methodological detailssingle-center, propensity-matched 1:1
- Single-center
- Propensity-matched 1:1
Main finding
As reported in the abstract
48-hour opioid consumption (MME)
P < 0.001
Observational data: associations, not effects.
Secondary outcomes
Median
| Outcome | Opioid agonist therapy | Controls | P value |
|---|---|---|---|
| Average pain score (NRS 0-10) | 4.6 (IQR 3.5–5.8) | 3.4 (IQR 2.1–4.7) | P < 0.001 |
| Peak pain score (NRS 0-10) | 7.0 (IQR 5.0–9.0) | 4.8 (IQR 3.7–6.6) | P < 0.001 |
| Postoperative LOS | P = 0.44 |
Postoperative LOS
- Similar in the two groups: 2.0 [2.0-3.0] days
Mental health diagnoses and opioid consumption
- Mental health diagnoses associated with increased opioid consumption
Original publication
Post-cesarean opioid consumption in patients on maintenance medication for opioid use disorder undergoing cesarean delivery with neuraxial anesthesia: a single-center retrospective propensity-matched cohort study (2016–2020). Int J Obstet Anesth. Published 25 July 2025. doi:10.
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