Post-cesarean Analgesia: Comparing Effectiveness of Staggered v. Simultaneous Therapies
Trial Parameters
Brief Summary
Cesarean delivery is a commonly performed surgical procedure associated with worse postpartum pain when compared to vaginal birth. Uncontrolled postpartum pain is associated with increased neonatal and maternal risks. Multimodal non-opioid pain medications, including acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) are the preferred first-line therapies. There is no standard practice, however, on best dosing schedules (ie staggered or different time v. simultaneous or same time). This protocol describes a randomized clinical trial aimed to determine whether staggered dosing of acetaminophen and NSAIDs in superior to simultaneous dosing in controlling post-cesarean pain.
Eligibility Criteria
Inclusion Criteria: * \>/= 34 weeks gestation * Singleton pregnancy * Delivery via cesarean section under regional anesthesia Exclusion Criteria: * Contraindication to acetaminophen or NSAIDs * Current or history of opioid use or misuse * Intrauterine fetal demise * Major congenital anomaly * Conversion to general anesthesia intra-op or planned general anesthesia * Mid-line vertical skin incision * Receipt of intraoperative local analgesia such as Transversus Abdominis Plan (TAP) block or wound infiltration