Abstract:
OBJECTIVE:To identify characteristics associated with high inpatient daily opioid consumption after cesarean delivery. METHODS:This is a retrospective cohort study of all cesarean deliveries performed under neuraxial anesthesia with neuraxial morphine, at a single institution from January 1, 2015, to December 31, 2015. Women with preoperative opioid use disorder or chronic opioid use were excluded. Sociodemographic data, medical comorbidities, use of anxiolytics or antidepressants, smoking history, nonopioid substance use, intrapartum and cesarean delivery characteristics, and opioid consumption data (converted to morphine milligram equivalents) were abstracted. We defined high opioid use as a mean daily opioid consumption, standardized to the postoperative length of stay (excluding the first 24 postoperative hours to account for neuraxial morphine), greater than the 75th percentile of all opioid consumption. We used multivariable Poisson regression, stratified by whether or not cesarean delivery was scheduled, to identify characteristics associated with high opioid consumption. RESULTS:Among 949 women who underwent cesarean delivery, the mean (SD) and median (interquartile range) daily opioid consumption was 48.6 (22.8) and 44.6 (36.6-66.6) morphine milligram equivalents, respectively. Among those women with high opioid consumption, the mean (SD) and median (interquartile range) daily opioid consumption was 78.8 (8.5) and 78.3 (72.9-83.5) morphine milligram equivalents, respectively. Daily opioid consumption among those with high consumption was similar among women with scheduled compared with unscheduled cesarean delivery. Sociodemographic characteristics were similar among women with and without high opioid consumption. No sociodemographic, antepartum, or intrapartum characteristics were associated with high opioid consumption for either women having unscheduled or scheduled cesarean deliveries. CONCLUSION:For a quarter of women undergoing cesarean delivery, daily consumption of opioids is equivalent to 10 tablets of oxycodone 5 mg daily. No characteristics were associated with high opioid use for women having a scheduled or unscheduled cesarean delivery. Understanding opioid consumption after cesarean delivery is critical to managing women's postoperative pain while decreasing opioid exposure and risks of long-term opioid use disorder.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Prabhu M,Dolisca S,Wood R,James K,Bateman BT,Barth WH Jr,Wylie BJdoi
10.1097/AOG.0000000000003087subject
Has Abstractpub_date
2019-02-01 00:00:00pages
354-363issue
2eissn
0029-7844issn
1873-233Xpii
00006250-201902000-00017journal_volume
133pub_type
杂志文章abstract:OBJECTIVE:Mifepristone and oral misoprostol are typically used for medical abortion in women up to 49 days of gestation, with a 36- to 48-hour interval between the medications. Alternative routes of misoprostol administration allow for use beyond 49 days of gestation. We designed this randomized, noninferiority trial t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/01.AOG.0000258298.35143.d2
更新日期:2007-04-01 00:00:00
abstract::In a randomized, double-blind clinical trial, 208 women who underwent abdominal hysterectomy received either cefazolin (N = 108) or moxalactam (N = 100) as perioperative antimicrobial prophylaxis. There were no differences between the two groups in rates of serious infection, minor wound infection, standard febrile mo...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1985-09-01 00:00:00
abstract::A preliminary report is made of 11 patients of childbearing age treated for symptomatic uterine prolapse by a suspension technic employing straps of external oblique aponeurosis according to the method of Williams and Richardson. In a relatively short period of follow-up, the operative results have been excellent in a...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1967-08-01 00:00:00
abstract::Almost 50% of married female residents become pregnant during their residency. The desire to have a baby and a concern about age influence the decision to become pregnant. Career concerns, financial issues, and child care are less important. In addition, support of the faculty or house staff is not a crucial factor in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of group B streptococci (GBS) colonization in a subsequent pregnancy in women with and without GBS colonization in an index pregnancy. METHODS:A retrospective cohort study of women who had two consecutive deliveries with the availability of GBS culture result at 35 to 37 weeks of g...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31817f5cb9
更新日期:2008-08-01 00:00:00
abstract::Bromocriptine and placebo were given to a group of 20 polycystic ovarian disease patients on a double-blind, cross-over basis. Patients were studied for three cycles: a baseline cycle without any medication, a placebo-treated cycle, and a bromocriptine-treated cycle with multiple plasma samples taken during the differ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1988-03-01 00:00:00
abstract:OBJECTIVE:To report our institutional experience with the accuracy and usefulness of cervical conization with frozen section before planned hysterectomy. METHODS:One hundred fifty-nine patients who planned to have hysterectomies for or with a concomitant diagnosis of cervical intraepithelial neoplasia (CIN) underwent ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract:OBJECTIVE:To assess long-term clinical and urodynamic outcomes of suburethral sling procedures using polytetrafluoroethylene grafts. METHODS:Between January 1986 and May 1991, 108 women underwent suburethral sling placement to treat genuine stress incontinence. At least 1 year after surgery, 62 women participated in a...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0029-7844(95)00098-C
更新日期:1995-07-01 00:00:00
abstract::The case report of a fatal result in an abortion requested because X-ray diagnostic studies of the gallbladder and intestine had been made during an undiagnosed early pregnancy is presented. A uterine vacuum aspirator had not been purchased by the hospital. A portable laboratory vacuum pump with an appropriate sucti...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1972-05-01 00:00:00
abstract::Evidence-based medicine, the new practice paradigm, is rapidly replacing medicine by authority, the traditional paradigm. In 1993, we introduced evidence-based practice into our Department of Obstetrics, Gynecology, and Reproductive Sciences at San Francisco General Hospital, University of California, San Francisco. W...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00184-S
更新日期:1995-09-01 00:00:00
abstract::The class of uterine malformations known as communicating uteri is characterized by two separate uterocervical cavities connected by an isthmic communication. Nine types have been described. We report the second proven case of a septate communicating uterus with double cervix. Investigation of secondary infertility in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVE:To examine the associations of maternal and child characteristics with early pregnancy maternal concentrations of testosterone, androstenedione, progesterone, 17-hydroxyprogesterone, and estradiol (E2). METHODS:We analyzed these hormones among 1,343 women with singleton pregnancies who donated serum samples ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182342b7f
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:To assess total time for evaluation of women with first-trimester pregnancy concerns in an early pregnancy unit compared with an emergency department (ED) within a single safety net hospital system. METHODS:We performed a retrospective cohort study at Denver Health Medical Center from May 1, 2017, to April 3...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004080
更新日期:2020-11-01 00:00:00
abstract::The rising cesarean birth rate is a matter of national concern, and the goal of clinical obstetricians is to contain this trend while maintaining good maternal and perinatal outcome. Despite published reports suggesting that excellent perinatal outcome can be achieved with modest cesarean birth rates, the general incr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::We present a series of 20 patients who underwent uterine suspension performed through a laparoscope, as part of conservative treatment for infertility and pelvic pain. The operative technique is easily mastered by a skilled laparoscopist who is prepared to deal with intra- or postoperative complications. Avulsion of t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-197805000-00011
更新日期:1978-05-01 00:00:00
abstract::A simple, rapid, economical, and accurate test to assess fetal pulmonary maturity on a 24-hour basis, 7 days a week, is urgently needed. A 15-minute test has been developed that correlates well with fetal pulmonary maturity. Optical density (OD) readings at 650 nm of greater than or equal to 0.15 in pigment-free, cent...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract::The effect on labor of administering ritodrine after a premature rupture of the membranes (PROM) was studied in a double-blind trial in 30 patients. The patients were selected according to the following criteria: 28 to 36 weeks' gestation, only 1 fetus, cervix dilated 4 cm or less, and absence of pyrexia or other sign...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract::The inability to make a definitive diagnosis in the fetus with a sonographically identified abnormality often results in parental and physician uncertainty. An antenatal chromosome evaluation could resolve this uncertainty. Forty-one fetuses with an abnormal ultrasound examination were tested for karyotypic abnormalit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::The authors describe a 5-year experience with 27 patients who had confirmed intrauterine scars at hysteroscopy, all of whom underwent resection of the scar. Of the 27, 14 became pregnant at least once, and 13 did not conceive. Hysteroscopic and hysterographic evidence of intrauterine scar was in general more severe in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1982-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of clinical trials registries in published obstetrics and gynecologic systematic reviews and meta-analyses. METHODS:We performed a metaepidemiologic study of systematic reviews between January 1, 2007, and December 31, 2015, from six obstetric and gynecologic journals (Obstetrics & Gyneco...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001204
更新日期:2016-02-01 00:00:00
abstract::Terbutaline was administered to 50 women, all diagnosed as being in labor prior to 36 weeks' gestation. In 47, uterine activity was initially arrested with intravenous therapy. The infusion rate required to arrest uterine activity ranged from 10 to 80 microgram/min and 21 of the 50 patients (42%) required more than on...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-197804000-00001
更新日期:1978-04-01 00:00:00
abstract:OBJECTIVE:To identify smartphone menstrual cycle tracking applications (apps) and evaluate their accuracy, features, and functionality. METHODS:In this systematic evaluation, we searched the Apple iTunes store for free menstrual cycle tracking apps for patient use. We considered an application accurate if menstrual cy...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001444
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To estimate the relation between undercoiling and overcoiling of the umbilical cord and adverse pregnancy outcome. METHODS:Umbilical cords and hospital records of 885 patients were studied in a cross-sectional study design. The umbilical coiling index was determined as the number of complete coils divided by...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000209197.84185.15
更新日期:2006-05-01 00:00:00
abstract::The recently developed sperm penetration assay (SPA) tests the functional capacity of sperm. It is based upon the ability of in vitro capacitated human spermatozoa to penetrate zona-free hamster eggs in vitro. The SPA was superior to seminal fluid analysis in predicting both fertility and infertility; in the predictio...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-05-01 00:00:00
abstract:OBJECTIVE:To compare intrauterine device (IUD) use at 6 months postpartum among women who underwent intracesarean delivery (during cesarean delivery) IUD placement compared with women who planned for interval IUD placement 6 or more weeks postpartum. METHODS:In this nonblinded randomized trial, women who were undergoi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0000000000000882
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:To examine the effectiveness of lidocaine spray compared with conventional lidocaine submucosal injection during a loop electrosurgical excision procedure (LEEP). METHODS:Women undergoing LEEP for any degrees of cervical intraepithelial neoplasia were invited to participate. The participants were randomly as...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0b013e31829d888e
更新日期:2013-09-01 00:00:00
abstract::Twelve patients with symptomatic septate uteri underwent hysteroscopic division of the uterine septum, monitored by concomitant laparoscopy, over a six-year period. The preoperative reproductive performance included 42 pregnancies, with only three viable deliveries. Ten of the 12 patients conceived within one year aft...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198602000-00017
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVE:To determine the frequency of intrauterine rubella infection in Taiwan. METHODS:One hundred three pregnant women with evidence of rubella infection were enrolled. Congenital rubella infection was diagnosed by testing specific immunoglobulin (Ig) M in fetal cord serum obtained from funipuncture or amniotic fl...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::The rollover test is useful in predicting and identifying subjects developing hypertensive disorders of pregnancy. The mechanisms responsible for positive tests are unclear, but a greater release of pressor substances occurring in subjects with positive tests has been proposed. The authors measured and compared heart ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract:OBJECTIVE:To estimate whether the loop electrosurgical excision procedure (LEEP) is associated with an adverse effect on the outcome of subsequent pregnancies. METHODS:A retrospective cohort study was performed. The study group comprised women who had a LEEP in Halifax County between 1992 and 1999 and then had a subse...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000151991.09124.bb
更新日期:2005-02-01 00:00:00