C Section Post-Op Rx

I doubt a narcotic would be started on PO Day 3 after discharge for most moms.

I didn't get any a year ago. Just plain motrin and Norco or percocet starting day #1. In fact, as soon as I got to the mom and baby floor, they took my iv out.

Sorry to give anecdotal evidence but I don't work mom and baby usually.

I am a Postpartum nurse and my c/s moms take Toradol or Ofirmev prn with either their Dilaudid PCA or Fentanyl PCE for 24hrs postop. From POD 1-3 when their pumps are already d/c'd, they are switched to Percocet and Motrin. And they will take that for the remaining of their stay and will go home on that rx. I know every facility is different, that's what happens on mine.

We give Toradol IV, then transition to Percocet or Norco once they're on POs.

We do what Klone's hospital does, with the exception that Toradol is given q6h for a full 24h before being dc'd. Once po meds are being taken, even if the toradol is still being given, they can take Norco on top of it if needed. Switch to motrin po once Toradol course completed.

why would you give a med like this, that hinders uterine contraction and inhibits platelets, in a post birth scenario?

We do what Klone's hospital does, with the exception that Toradol is given q6h for a full 24h before being dc'd. Once po meds are being taken, even if the toradol is still being given, they can take Norco on top of it if needed. Switch to motrin po once Toradol course completed.

Yep, that's actually what we do too!

why would you give a med like this, that hinders uterine contraction and inhibits platelets, in a post birth scenario?

Because it has been proven safe (I actually worked as a mother baby nurse when some of the trials for this drug were going on to determine if it was safe for breastfeeding, among other things, way back in the day), and because it is excellent for post operative pain control.

A randomized, controlled trial to compare ketorolac tromethamine versus placebo after cesarean section to reduce pain and narcotic usage. - PubMed - NCBI

Tips From Other Journals - American Family Physician

My wife had c section with twins and she was on either a fentanyl or dilaudid PCA for 2 days, then switched to norco 10 for home. She had a lot of pain from her c section. Tylenol/toradol didn't do much for her.

Toradol worked great for both of my c-sections. I was onto motrin only at the time of discharge. Everyone is different. Edited to add for clarity: not all women have a great recovery from c-sections. However, toradol has been proven effective at the bedside for cutting down on post op pain for a lot of women, as well as several other measures that are backed by research.

My old hospital gave Ofirmiv in the OR (1 bottle--I think 1 gram? Not sure, I was the baby nurse lol), then as soon as mom started feeling discomfort they'd offer Motrin and do scheduled Motrin for 24 hours with either Percocet or Roxy and Tylenol for breakthrough pain (the Motrin + Percocet was standard for all new moms). Not sure what else they could offer if a section still had severe pain as I never cared for a fresh C-section.

It sounds like pain management has improved since I had my last c-section, in 2000. I got zippo after the IV came out. When it was time to go home, I said to the nurses, You know, getting in the car and riding home's really going to hurt. I was given a single pill of something for the drive, walked into the house with my baby, and conked out. And that was that.