Pain Management in Pregnant Women with Opioid Use Disorder: A Systematic Review

Background: The prevalence of opioid use disorder (OUD) among pregnant individuals has risen significantly, posing challenges in managing labor and postpartum pain. Factors such as opioid tolerance, opioid-induced hyperalgesia, and concerns about relapse complicate analgesic strategies. Despite these complexities, evidence-based guidelines for pain management in this population remain limited. Hypothesis: Pregnant women with OUD experience disparities in pain management during labor and postpartum periods, leading to suboptimal outcomes. Methods: A systematic review was conducted, analyzing peer-reviewed studies from databases including PubMed and Embase. Inclusion criteria encompassed studies focusing on pain management in pregnant women with OUD. Data extraction focused on pain scores, analgesic use, patient and provider perspectives, and clinical outcomes. Results: ·Women with OUD reported higher pain scores postpartum compared to those without OUD. ·Patients expressed concerns about inadequate pain control and limited analgesia options. ·Providers acknowledged challenges in balancing effective pain management with the risk of relapse. ·Women maintained on buprenorphine experienced more pain and required more analgesics after C-sections ·A lack of standardized protocols for managing pain in this population was evident. Conclusion: To enhance pain management strategies for pregnant women with OUD, future research and clinical efforts should focus on development of evidence-based guidelines, provider education and training, and assessment of non-opioid analgesics.