Comparing Staggered and Simultaneous Dosing of Acetaminophen and NSAIDs for Pain Control After Cesarean Delivery

What this Trial Is About

Cesarean delivery is a common surgical procedure with increasing rates in the US, accounting for 32% of all births in 2022. Parents who deliver by cesarean often experience more postpartum pain compared to vaginal births. Uncontrolled postpartum pain can lead to physical complications like venous thrombosis and pneumonia, as well as psychological distress, affecting infant-parent bonding and breastfeeding. This trial evaluates whether taking acetaminophen and NSAIDs in a staggered schedule is better than taking them simultaneously to control post-cesarean pain. The study compares two approaches of administering non-opioid pain medicines one group takes acetaminophen and NSAIDs 3 hours apart staggered, while the other takes both at the same time simultaneous. Acetaminophen is given at 1000 mg every 6 hours, and NSAIDs include ketorolac 30 mg every 6 hours for the first 24 hours followed by ibuprofen 600 mg every 6 hours. The trial randomly assigns participants to these two groups and monitors pain control after cesarean delivery. Participants are mothers delivering by cesarean under regional anesthesia with singleton pregnancies at 34 or more weeks gestation. Researchers assess postpartum pain at multiple time points up to 48 hours after delivery and track opioid use from surgery until hospital discharge. Other measures include length of hospital stay, infant feeding at discharge, patient satisfaction, and opioid use at home up to two weeks post-surgery. The study aims to improve pain management during the critical postpartum period while minimizing opioid exposure.

Post-cesarean Analgesia: Comparing Effectiveness of Staggered v. Simultaneous Therapies