Antenatal and Postnatal Analgesia

Bisson, D; Newell, Simon; Laxton, C.; Gynaecologists,

doi:10.1111/1471-0528.15510

Cited by 27 publications

(9 citation statements)

References 40 publications

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“…The metabolism of dihydrocodeine is not affected by individual metabolic capacity as the analgesic effect is produced by the parent drug, in contrast to codeine which is a prodrug. Dihydrocodeine may be the preferred weak opioid for postoperative use in the breastfeeding woman, due to its cleaner metabolism compared with codeine and wide experience of use after caesarean section [36], although the NHS Specialist Pharmacy Service recommend observing the woman for signs of significant opioid adverse effects [24].…”

Section: Transfer To Breast Milk Of Drugs Used Peri‐operativelymentioning

confidence: 99%

Guideline on anaesthesia and sedation in breastfeeding women 2020

Mitchell

Jones²,

Winkley

et al. 2020

Anaesthesia

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Breastfeeding has many health benefits for the mother and infant. Women who are breastfeeding may require anaesthesia or sedation. Concerns regarding the passage of drugs into breast milk may lead to inconsistent advice from professionals. This can sometimes result in the interruption of feeding for 24 hours or longer after anaesthesia, or expressing and discarding ('pumping and dumping') breast milk; this may contribute to early cessation of breastfeeding. However, there are data regarding the transfer of most anaesthetic drugs into breast milk. We advise that breastfeeding is acceptable to continue after anaesthesia and should be supported as soon as the woman is alert and able to feed, without the need to discard breast milk. We provide evidence-based information on the pharmacokinetics of drugs commonly used during anaesthesia so that professionals can undertake a risk-benefit discussion with the woman. We advise the development of local policies that aid logistical planning and guide staff to facilitate breastfeeding during the woman's hospital stay.

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Section: Transfer To Breast Milk Of Drugs Used Peri‐operativelymentioning

confidence: 99%

Guideline on anaesthesia and sedation in breastfeeding women 2020

Mitchell

Jones²,

Winkley

et al. 2020

Anaesthesia

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“…According to the U.S. FDA and RCOG, paracetamol is the safest analgesic for pregnant women and children when given at the lowest effective dose and for the shortest duration possible. All NSAIDs if needed should be used under medical supervision, not OTC for the targeted subpopulation, pregnant women, with the lowest dose and shortest duration [ 4 , 35 ]. Taken together, comparing the findings of our study regarding the usage of analgesics in the first trimester, 50% of women used analgesics in the first trimester of their pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Knowledge of Analgesic Drugs Utilization during Pregnancy among Women in Saudi Arabia: A Cross-Sectional Study

AlSaeed

Elmaghraby

2021

IJERPH

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Background: Pain is a common compensation mechanism in pregnant women that they may face during gestation due to physiological changes. Paracetamol and non-steroidal anti-inflammatory drugs are the most administered analgesic drugs worldwide. Therefore, safety and efficacy are important measures for the use of analgesics during pregnancy. Objective: Assess the knowledge of analgesic drug utilization among Saudi pregnant women. Method: We conducted a self-administered survey with an electronic questionnaire via Google Drive among a sample of 406 Saudi women. Results: About half of the respondents took analgesics during the first trimester, and 52.5% of women have used analgesics at least once without any medical advice during their gestation. Most participants agreed that paracetamol is the safest and effective analgesic drug during pregnancy, yet 61.8% of women are not aware that analgesics could be detrimental to the fetus if inappropriately administered in the third trimester. Conclusion: Participants have a good perception of the safest and most effective analgesic drug during pregnancy, but they have poor knowledge about analgesics’ side effects.

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“…UKTIS notes that findings of a possible increased risk of cryptorchidism in male offspring following paracetamol use during pregnancy are conflicting [18]. Current Royal College of Obstetricians (RCOG) guidance is that paracetamol remains safe for use during pregnancy and breastfeeding, and its use in any trimester does not appear to increase the risk of major birth defects [19].…”

Section: Pain Management: Conventional Analgesics Paracetamolmentioning

confidence: 99%

“…There has been one death, however, in the 8-month-old breastfed infant of a woman addicted to tramadol, although the death was not definitely attributable to tramadol exposure in breastmilk [29]. Current RCOG advice states that tramadol can continue to be used (with caution) during breastfeeding and the lowest effective dose should be used for the shortest time possible [19]. The following recommendations for tramadol were based on evidence as shown in Supplementary Table S3…”

Section: Tramadolmentioning

confidence: 99%