Dr. Landau authors important new protocols for obstetric pain

A sweeping change in pain management protocols in obstetrical patients at CUIMC was profiled in Anesthesiology News last week.  The goal of the change is to significantly reduce use of opioids for pain. According to Dr. Ruth Landau, the architect of the new intervention, the “administration of opioids to obstetric patients is very unique to North America.” Dr. Landau and her team presented the protocol and its results so far at a well-received presentation at the 2019 annual meeting of the American Society of Anesthesiologists.

The earliest step in the plan, which was first implemented in 2017, was to conceptualize the goal for faculty and staff by formally mapping the issues of opioid use in society and in the medical establishment, followed by an overview of the new paradigm, which replaces routine use of opioids with a combination of nonprescription pain medications. Most patients now are treated with ibuprofen and acetaminophen, and opioid medications are reserved only for patients with moderate to severe pain. Another essential strategy in the protocol is the oversight of patients by anesthesiologists from the perioperative period through discharge, ensuring a cohesive opioid-sparing pain management approach.  Dr. Landau and her team are pleased with the results of the initiative so far.  She says her “goal in five years is to have women who take opioids in the hospital be the exception.” View a PDF of the article here.