Post-cesarean Analgesia: Comparing Effectiveness of Staggered v. Simultaneous Therapies
PACESS: Post-cesarean Analgesia: Comparing Effectiveness of Staggered v. Simultaneous Therapies
Thomas Jefferson University
825 participants
Aug 26, 2025
INTERVENTIONAL
Summary
Cesarean delivery is a commonly performed surgical procedure associated with worse postpartum pain when compared to vaginal birth. Uncontrolled postpartum pain is associated with increased neonatal and maternal risks. Multimodal non-opioid pain medications, including acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) are the preferred first-line therapies. There is no standard practice, however, on best dosing schedules (ie staggered or different time v. simultaneous or same time). This protocol describes a randomized clinical trial aimed to determine whether staggered dosing of acetaminophen and NSAIDs in superior to simultaneous dosing in controlling post-cesarean pain.
Eligibility
Inclusion Criteria3
- >/= 34 weeks gestation
- Singleton pregnancy
- Delivery via cesarean section under regional anesthesia
Exclusion Criteria7
- Contraindication to acetaminophen or NSAIDs
- Current or history of opioid use or misuse
- Intrauterine fetal demise
- Major congenital anomaly
- Conversion to general anesthesia intra-op or planned general anesthesia
- Mid-line vertical skin incision
- Receipt of intraoperative local analgesia such as Transversus Abdominis Plan (TAP) block or wound infiltration
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Interventions
Acetaminophen 1000 mg q6H
NSAID (ketorolac 30 mg q6H for first 24 hours post-op followed by ibuprofen 600 mg q6H)
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07102641