Essentials - Acute Post-Operative Pregnancy Pain with At-Risk Women-Recording - Essentials - Acute Post-Operative Pregnancy Pain with At-Risk Women

Video Transcription
Video Summary
In this video, Dr. Marla Kushner discusses the topic of acute pain in pregnant and post-operative at-risk women. She begins by introducing herself and mentioning her affiliation with Alkermes. Dr. Kushner then presents a cartoon about mid-husbands, and humorously starts the lecture. She states that her goal is to address concerns about access to opioids and to discuss new guidelines and alternative pain management options, including osteopathic manipulative medicine. The lecture covers various topics such as substance use disorder, opioid problem, patient types, pain management options, treatment, and presents different cases.<br /><br />Dr. Kushner explains that addiction is a treatable chronic medical disease involving brain circuits, genetics, environment, and life experiences. She outlines the DSM-5 criteria for substance use disorder and opioid use disorder. The lecture discusses the causes of the opioid epidemic, including pharmaceutical companies and over-prescribing by physicians. Dr. Kushner highlights the alarming statistics of opioid overdoses and her personal experiences in primary care. She categorizes patients into three types: those without a history of substance use disorder, those with a family history of substance use disorder, and those with a diagnosed substance use disorder.<br /><br />The lecture emphasizes the importance of screening for substance use disorder and providing education and options for pain management. Dr. Kushner shares her own childbirth experience and the need for appropriate pain medication. She explains screening tools like the CAGE questionnaire and the opioid risk tool, which assess the risk of opioid abuse. The lecture also discusses the opioid crisis during pregnancy and its consequences, including complications and increased risks for the mother and fetus.<br /><br />Dr. Kushner mentions the American Society of Addiction Medicine guidelines on treating chronic pain and emphasizes the need for non-pharmacologic and non-opioid therapy options. The lecture highlights the importance of risk assessment, use of urine drug testing, and avoiding benzodiazepine use alongside opioids. The video concludes with a discussion on integrating osteopathic manipulative therapy into pain management during and after pregnancy.<br /><br />The lecture includes two case studies that illustrate opioid dependency, withdrawal, and treatment plans with Suboxone. It highlights the importance of support through programs like Alcoholics Anonymous (AA) and the need for proper prenatal care for pregnant women with substance use disorders. The lecture concludes with Dr. Kushner offering to answer questions via email.
Keywords
acute pain
pregnant women
post-operative women
opioids
pain management
substance use disorder