Prevention of Persistent Opioid Use in Mothers

Summary

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.

Timeline

Start

2018-09-17

Primary completion

2020-07-02

Completion

2021-04-10

Outcome

Missed primary endpoint

paper There was no difference in time to opioid cessation between patients who were randomly assigned to be treated with gabapentin PMID 37043404 ↗

paper The hazard ratio was 1.1 (95% confidence interval [CI], 0.67-1.8), P = .65. PMID 37043404 ↗

Publications

• Background Komatsu R, Carvalho B, Flood PD. Recovery after Nulliparous Birth: A Detailed Analysis of Pain Analgesia and Recovery of Function. Anesthesiology. 2017 Oct;127(4):684-694. doi: 10.1097/ALN.0000000000001789.
• Background Komatsu R, Carvalho B, Flood P. Prediction of outliers in pain, analgesia requirement, and recovery of function after childbirth: a prospective observational cohort study. Br J Anaesth. 2018 Aug;121(2):417-426. doi: 10.1016/j.bja.2018.04.033.
• Fowler C, Chu AW, Guo N, Ansari JR, Shafer SL, Flood PD. Outpatient Treatment With Gabapentin in Women With Severe Acute Pain After Cesarean Delivery Is Ineffective: A Randomized, Double-Blind, Placebo-Controlled Trial. Anesth Analg. 2023 Jun 1;136(6):1122-1132. doi: 10.1213/ANE.0000000000006429. Epub 2023 Apr 12.

Drugs

Evaluation	Drug	Modality	Dose	Route
Subject	Gabapentin	Unknown	300 mg	—

Indications