Managing postcaesarean section pain with opioid analgesia and the effect on breastfeeding
A literature review
DOI:
https://doi.org/10.14528/snr.2024.58.3.3256Keywords:
pain, delivery, opioid, mobilization, nursingAbstract
Introduction: Pain after caesarean section is an expected event that can affect the patient's recovery and first attempts at breastfeeding. The aim of this review was to determine the relationship between opioid pain management after caesarean section and support during the first breastfeeding attempts.
Methods: A descriptive method was used to conduct a literature search in the PubMed Central, ScienceDirect, and Google Scholar databases, which included literature published between 2013 and 2023. A combination of the following keywords was used in the search: "pain", "delivery", "opioid", "mobilisation" and "nursing". Primary sources were selected according to predefined inclusion and exclusion criteria. The search process and selection are illustrated using the PRISMA diagram. A thematic analysis was conducted by coding the data retrieved.
Results: The literature search yielded nine articles addressing the status of opioid pain management and breastfeeding after caesarean section. The results of the literature search were critically appraised using the MML tool. The main content pertained to the outcomes of identifying different interventions for the management of postoperative pain and initiation of breastfeeding after caesarean section.
Discussion and conclusion: In general, patients in different countries were found to be at higher risk of inadequate forms of pain management after caesarean section. We also identified the key research gaps that should be addressed to support further public health interventions for more appropriate pain management and the promotion of and support with breastfeeding after caesarean section.
Downloads
Metrics
References
Ahmadi, M., Moosavi, S., Moosavi, M., & Ghasemi Y. (2015). Cessation of exclusive breastfeeding in caesarean section mothers: Need more attention. American Journal of Medicine and Medical Science, 5(2), 82−86. http://article.sapub.org/10.5923.j.ajmms.20150502.04.html
Brandt Eriksen, M., & Faber Frandsen, T. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: A systematic review. Journal of Medical Library Association, 106(4), 420−431. https://doi.org/10.5195%2Fjmla.2018.345 PMid:30271283; PMCid:PMC6148624
Brown, H. (2020). Opioid management in pregnancy and postpartum. Obstetrics and Gynecology Clinics of North America, 47(3), 421−427. https://doi.org/10.1016/j.ogc.2020.04.005 PMid:32762927
Bjornstad, J., & Reder, J. (2020). Post-operative pain after caesarean section. Tidsskriftet den Norske Legeforening, 140(1), 1−5. https://doi.org/10.4045/tidsskr.19.0506
Boysen, P. G., Patel, J. H., & King, A. N. (2023). Brief history of opioids in perioperative and periprocedural medicine to inform in the future. Ochsner Journal, 23(1), 43−49. https://doi.org/10.31486%2Ftoj.22.0065 PMid:36936479; PMCid:PMC10016219
Carvalho, B., & Butwick, A. (2017). Post-cesarean delivery analgesia. Best Practice & Research Clinical Anaesthesiology, 31(1), 69−79. https://doi.org/10.1016/j.bpa.2017.01.003 PMid:28625307
Chao, A., Pasca, I., Alschuler, M., Lee, J., Woodfin, M., Pugh, J., Austin, B., Ringer, M., & Ramsingh, D. (2019). Comparison of postopereative opioid consumption and pain scores in primary versus repeat cesarean delivery in opioid naïve patients. Journal of Clinical Medicine, 8(12), Article 2221. https://doi.org/10.3390/jcm8122221 PMid:31888170; PMCid:PMC6947434
Chang, C.-Y., Tu, Y.-K., Kao, M.-C., Shih, P.-C., Su, I.-M., Lin, H.-Y., Chien, Y.-J., Wu, M. -Y., Chen, C.-H., & Chen, C.-T. (2022). Effects of opioids administered via intravenous or epidural patient-controlled analgesia after caesarean section: A network meta-analysis of randomised controlled trials. eClinicalMedicine, 56(2), Article 101787. https://doi.org/10.1016/j.eclinm.2022.101787 PMid:36590790; PMCid:PMC9800204
Cohen S., Alexander D., Krebs N., Young B., Cabana M., Erdmann P., Hays, N. P., Bezold, C. P., Levin-Sparenberg, E., Turini, M., & Saavedra, J. M. (2018). Factors associated with breastfeeding initiation and continuation: A meta-analysis. The Journal of Pediatrics, 203(21), 190–196. https://doi.org/10.1016/j.jpeds.2018.08.008 PMid:30293638
Dalili, H., Shariat, M., Nayeri, F., Emami, Z., Sahebi, R., & Sahebi, L. (2020). Duration of breastfeeding and maternalrelated factors in Iran: Systematic review and meta-analysis. Journal of Pediatric Nursing, 54(1), 23–30. https://doi.org/10.1016/j.pedn.2020.04.011 PMid:32553476
Daoust, R., Paquet, J., Cournoyer, A., Piette, E., Morris, J., Lessard, J., Castonguay, V., Williamson, D., & Chauny, J. M. (2020). Side effects from opioids used for acite pain after emergency department discharge. American Journal of Emergency Medicine, 38(4), 695–701. https://doi.org/10.1016/j.ajem.2019.06.001 PMid:31182367
Fassoulaki, A., Staikou, C., Tsaroucha, A., Micha, G., & Paraskeva, A. (2021). Acute and chronic pain after cesarean delivery under subarachnoid anaesthesia. Is postoperative analgesia adequate: A cohort observational study. Journal of Clinical Medicine, 16(1), 41–47. https://doi.org/10.26574%2Fmaedica.2020.16.1.41 Pmid:34221155; PMCid:PMC8224706
Gianni, M. L., Lanzani, M., Consales, A., Bestetti, G., Colombo, L., Bettinelli, M. E., Plevani, L., Morniroli, D., Sorrentino, G., Bezze, E., Zanotta, L., Sannino, P., Cavallaro, G., Villamor, E., Marchisio, P., & Mosca, F. (2020). Exploring the emotional breastfeeding experience of first-time mothers: Implications for health support. Frontiers in Pediatrics, 8(1), 1–7. https://doi.org/10.3389/fped.2020.00199 PMid:32457856; PMCid:PMC7221017
Harrison, R., Jones, B., Gardner, P., & Lawton, R. (2021). Quality assessment with diverse studies (QuADS): An appraisal tool for mehodological and reporting quality in systematic reviews of mixed- or multi-method studies. BMV Health Services Research, 21, Article 144. https://doi.org/10.1186/s12913-021-06122-y PMid:33588842; MPCid:PMC7885606
Hobbs, A., Mannion, A., McDonald, S., Brockway, M., & Tough S. (2016). The impact of cesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy and Childbirth, 16(1), Article 90. https://doi.org/10.1186/s12884-016-0876-1 PMid:27118118; PMCid:PMC4847344
Hooda, R., Mali, N., Pathak, P., More, H., & Singh, V. (2023). Impact of postoperative pain on early initiation of breastfeeding and ambulation after cesarean section: A randomised trial. Breastfeeding Medicine, 18(2), 132−137. https://doi.org/10.1089/bfm.2022.0208 PMid:36800334
Ismail, S., Afshan, G., Monem, A., & Ahmed, A. (2012). Postoperative analgesia following caesarean section: Intravenous patient controlled analgesia versus conventional continuous infusion. Open Journal of Anesthesiology, 2(4), 120−126. http://dx.doi.org/10.4236/ojanes.2012.24028
Kling Oms Lii, D. K., Haile, Z., Oms Lii, J. F., & Chertok, I. (2016). Association between method of delivery and exclusive breastfeeding at hospital discharge. Journal of American Osteopathic Medicine, 116(7), 430−439. https://doi.org/10.7556/jaoa.2016.087 PMid:27367948
Kodeks etike v zdravstveni negi in oskrbi Slovenije in Kodeks etike za babice Slovenije. (2014). Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.
Komatsu, R., Nash, M., Mandalia, S., Dinges, E., Kamal, U., Singh, D., El-Omrani, H., Anwar, A., Delgado, C., Ziga, T., & Carvalho, B. (2022). In-hospital opioid consumtion after the previous cesarean delivery weakly predicts opioid consumption after index delivery: A retrospective cohort study. Anesthesia & Analgesia, 134(6), 1280−1287. https://doi.org/10.1213/ane.0000000000005918 PMid:35130195
Landau, R., Cavanaugh, P. F., & DiGiorgi, M. (2023). Persistent opioid use after cesarean delivery in the United States of America: A systematic review. International Journal of Obstetric Anesthesiology, 54(1), Article 103644. https://doi.org/10.1016/j.ijoa.2023.103644 PMid:37004281
Landau, R, Romanelli, E, Daoud, B, Shatil, B, Zheng, X, Corradini, B., Aubey, J., Wu, C. Ha, C., & Guglielminotti, J. (2021). Effects of a stepwise opioid-sparing analgesic protocol on in-hospital oxycodone use and discharge prescription after cesarean delivery. Regional Anesthesia & Pain Medicine, 46(2), 151−156. http://dx.doi.org/10.1136/rapm-2020-102007 PMid:33172902
Mary J. F., Sindhuri R., Kumaran A. A., & Dongre A. (2021). Early initiation of breastfeeding and factors associated with its delay among mothers at discharge from a single hospital. Clinical and Experimental Pediatrics, 65(4), 201–218. https://doi.org/10.3345/cep.2021.00129 PMid:34665960; PMCid:PMC8990951
O'Connor, A., Smith, J., O'Brien, L., Lamarche, K., Byers, N., & Nichols, S. (2022). Peripartum and postpartum analgesia and pain in women prescribed buprenorphine for opioid use disorder who deliver by cesarean section. Substance Abuse, 16(4), Article 16. https://doi.org/10.1177/11782218221107936 PMid:35754980; PMCid:PMC9218889
Oommen, H., Oddbjorn Tveit, T., Eskedal, L., Myr, R., Swanson, D., & Vistad, I. (2021). The association between intrapartum opioid fentanyl and early breastfeeding: A prospective observational study. Acta Obstetricia et Gynecologica Scandinavica, 100(12), 2294−2302. https://doi.org/10.1111/aogs.14268 PMid:34622936
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo- Wilson, E., McDonald, S., ... Moher, D. (2021). The PRISMA 2020 statement: An update guideline for reporting systematic reviews. BMJ, 371, Article n71. https://doi.org/10.1136/bmj.n71 PMid:33782057; PMCid:PMC8005924
Patel, K., & Zakowski, M. (2021). Enhanced recovery after cesarean: Current and emerging trends. Current Anesthesiology Reports, 11(2), 136–144. https://doi.org/10.1007%2Fs40140-021-00442-9 PMid:33679253; PMCid:PMC7921280
Patzkowski, M., Hammondm K., Herrera, G., & Highland, K. (2023). Factors associated with postoperative opioid prescribing after primary elective cesarean section. Military Medicine, 188(1/2), 339−342. https://doi.org/10.1093/milmed/usab263 PMid:34226932
Polit, D. F., & Beck, C. T. (2018). Esentials of nursing research: Appraising evidence for nursing practice. Lippincott Williams & Wilkins. Roofthooft, E., Joshi, G.P., Rawal, N., & Van de Velde, M. (2021).
Prospect guideline for elective caesarean section: Updated systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia, 76(5), 665−680. https://doi.org/10.1111/anae.15339 PMid:33370462; PMCid:PMC8048441
Sangkum, L., Thamjamrassri, T., Arnuntasupakul, V., & Chalacheewa, T. (2021). The current consideration, approach and management in postcesarean delivery pain control: A narrative review. Anesthesiology Research and Practice, 2021, Article 2156918. https://doi.org/10.1155/2021/2156918 PMid:34589125; PMCid:PMC8476264
Streubert, H., & Carpenter, D. (2011). Qualitative research in nursing: Advancing the humanistic imperative. Wolters Kluwer.
Vila-Candel, R., Martin, A., Escuriet, R., Castro-Sanchez, E., & Soriano-Vidal, F. J. (2020). Analysis of cesarean section rates using the robson classification system at a university hospital in Spain. International Journal of Environmental Reserach and Public Health, 17(5), Article 1575. https://doi.org/10.3390%2Fijerph17051575 PMid:32121364; PMCid:PMC7084406
Visic, U., Stopar Pintaric, T., Albreht, T., Blajic, I., & Lucovnik, M. (2021). Multimodal stepwise analgesia for reducing opioid consumtion after cesarean delivery. Clinical and Experimental Obstetrics & Gynecology, 48(5), 1162−1166. https://doi.org/10.31083/j.ceog4805186
Višić, U., Stopar-Pintarič, T., Blajić, I., Albreht, T., & Lučovnik, M. (2022). Vpliv multimodalne analgezije na samostojnost otročnic pri osebni higieni, skrbi za novorojenčka in dojenja po carskem rezu: retrospektivna kohortna raziskava. Obzornik zdravstvene nege, 56(3), 194−199. https://doi.org/10.14528/snr.2022.56.3.3137
Wen, L., Hilton, G., & Carvalho, B. (2015). The impact of breastfeeding on postpartum pain after vaginal and caesarean delivery. Journal of Clinical Anesthesia, 27(1), 33−38. https://doi.org/10.1016/j.jclinane.2014.06.010 PMid:25468582
World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 PMid:24141714
Zanardo V., Svegliado G., Cavallin F., Giustardi A., Cosmi E., Pietro L., & Trevisanuto, D. (2010). Elective caesarean delivery: Does it have a negative effect on breastfeeding? Birth Issues in Perinatal Care, 37(4), 275−279. https://doi.org/10.1111/j.1523-536X.2010.00421.x PMid:21083718
Zipursky, J., Gomes, T., Everett, K., Calzavara A., Paterson, M., Austin, P., Mamdani, M. M., Ray, J. G., & Juurlink, D. N. (2023). Maternal opioid treatment after delivery and risk of adverse infant outcomes: Population based cohort study. BMJ, 380, Article 074005. https://doi.org/10.1136/bmj-2022-074005 PMid:36921977; PMCid:PMC10015218
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Slovenian Nursing Review
This work is licensed under a Creative Commons Attribution 4.0 International License.
As the author undersigned hereby, I transfer, assign, or otherwise convey the following authorship rights as comprised in the Copyright and Related Rights Act (CRRA) to the Slovenian Nursing Review, Ob železnici 30A, 1000 Ljubljana: the right of reproduction - the exclusive right to fix the work in a material medium or in another copy directly or indirectly, temporarily or permanently, by any means and in any digital form, in whole or in part (CRRA, Article 23); the right of distribution (CRRA, Article 24); the right of making a work available and accessible through the internet (CRRA, Article 32a); the right of transformation, especially the exclusive right to translate a pre-existing work (CRRA, Article 33). The transfer of author rights applies to the article in its entirety, including pictorial and/or graphic works and possible supplements. The transfer of rights is exclusive and unlimited in duration or territory.