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Clinical Perspectives: Split-Dose Oxycodone Protocol Reduces Opioid Use After C-Sections

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Clinical Perspectives: Split-Dose Oxycodone Protocol Reduces Opioid Use After C-Sections

Welcome to Clinical Perspectives, a new column from Mommy Matters. We cull the newest, most important pregnancy and postpartum news and break it down into a few takeaway points you need to know. Also, we have our own medical expert, Dr. Shirazian, who reviews each article and adds the clinical perspective. If you are interested in learning more on your own, our MD-trusted sources include the American College of Obstetricians and GynecologistsAmerican Academy of Pediatrics, and Very Well Health.


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July 8, 2019 - A new study published in Obstetrics and Gynecology found that using a split dose of oral oxycodone medication for women who’d just had C-sections greatly reduced opioid use in the first 48 hours after delivery.

Key Takeaways:

  • The study looked at two groups of patients immediately after C-section delivery. The first group was given a one-time dose of oral oxycodone based on their pain levels (5 mg if they reported a pain level of 4 out of 10 or lower, and 10 mg if they reported 5 out 10 or above). 
  • The second group was given half of those doses initially (2.5 mg or 5 mg). A nurse then checked on the patient after one hour to see if the second half of the dose was still desired.
  • The second group receiving this split-dose approach used far fewer opioids: there was a 56% decrease in median opioid use in the first 48 hours after delivery. 
  • Half as much vomiting and nausea was also reported by the second group compared to the first group. Excessive opioid use can cause vomiting and nausea, so decreasing opioid intake lessens these unpleasant side effects. 
  • The new protocol was developed to be patient-centered, giving patients more agency in how much post-delivery pain medication they would like and minimizing unpleasant symptoms of high opioid usage.
  • If you are planning on having a C-section, consider discussing your pain management plan with your care team to see if they currently use a split-dose protocol or are open to trying this option with you.

You can read the original article here.


Disclaimer: This is general medical information and not specific medical advice.  It does not and should not replace diagnosis or treatment by your healthcare provider. If you are seeking personal recommendations, advice, and/or treatment, please consult your physician. If you have an emergency, you should contact 911 or go to the nearest Emergency Room.