Evidence map›Paper›PMID 38461452›Full record

ArticleJournal of anesthesia2024

Neuraxial clonidine is not associated with lower post-cesarean opioid consumption or pain scores in parturients on chronic buprenorphine therapy: a retrospective cohort study.

Michael G Taylor, Jeanette R Bauchat, Laura L Sorabella, Jonathan P Wanderer, Xiaoke Feng, Matthew S Shotwell, Holly B Ende

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Article in Journal of anesthesia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Michael G TaylorDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, USA. taylormg@med.umich.edu.ORCID 0000-0003-2955-7032
Jeanette R BauchatDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, USA.
Laura L SorabellaDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, USA.
Jonathan P WandererDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, USA.
Xiaoke FengDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, USA.
Matthew S ShotwellDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, USA.
Holly B EndeDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAdequate post-cesarean delivery analgesia can be difficult to achieve for women diagnosed with opioid use disorder receiving buprenorphine. We sought to determine if neuraxial clonidine administration is associated with decreased opioid consumption and pain scores following cesarean delivery in women receiving chronic buprenorphine therapy.

methodsThis was a retrospective cohort study at a tertiary care teaching hospital of women undergoing cesarean delivery with or without neuraxial clonidine administration while receiving chronic buprenorphine. The primary outcome was opioid consumption (in morphine milligram equivalents) 0-6 h following cesarean delivery. Secondary outcomes included opioid consumption 0-24 h post-cesarean, median postoperative pain scores 0-24 h, and rates of intraoperative anesthetic supplementation. Multivariable analysis evaluating the adjusted effects of neuraxial clonidine on outcomes was conducted using linear regression, proportional odds model, and logistic regression separately.

results196 women met inclusion criteria, of which 145 (74%) received neuraxial clonidine while 51 (26%) did not. In univariate analysis, there was no significant difference in opioid consumption 0-6 h post-cesarean delivery between the clonidine (8 [IQR 0, 15]) and control (1 [IQR 0, 8]) groups (P = 0.14). After adjusting for potential confounders, there remained no significant association with neuraxial clonidine administration 0-6 h (Difference in means 2.77, 95% CI [- 0.89 to 6.44], P = 0.14) or 0-24 h (Difference in means 8.56, 95% CI [- 16.99 to 34.11], P = 0.51).

conclusionIn parturients receiving chronic buprenorphine therapy at the time of cesarean delivery, neuraxial clonidine administration was not associated with decreased postoperative opioid consumption, median pain scores, or the need for intraoperative supplementation.

Indexed as

Analgesics, OpioidBuprenorphineCesarean SectionClonidinePostoperative PainAdultCohort StudiesFemaleHumansOpiate Substitution TreatmentOpioid-Related DisordersPain MeasurementPregnancyRetrospective StudiesAnalgesics, OpioidBuprenorphineClonidineChronic buprenorphine therapyNeuraxial clonidineOpioid use disorderPost-cesarean analgesia

Identifiers

PMID38461452

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