Ibuprofen and Acetaminophen Versus Ibuprofen and Acetaminophen Plus Hydrocodone for Analgesia After Cesarean Section

Women will be approached priors to discharge from the hospital, if they meet inclusion criteria and consent for the study, they will be randomized to one of two possible analgesic regimens. They will be followed at 1-2 weeks and 4-6 weeks after discharge to assess pain level.

Inclusion criteria

• English or Spanish speaker women who had a cesarean section

Exclusion criteria

• Inability or refusal to provide informed consent.
• Reported current or prior opioid or benzodiazepine use disorder, including urine drug screen positive for a non prescribed opioid or benzodiazepine upon admission or during prenatal care.
• Current treatment with methadone, buprenorphine or buprenorphine plus naloxone.
• Known alcoholism disorder.
• Severe renal or hepatic impairment.
• Known creatinine > 1.5 at the time of delivery or severe proteinuria leading to diagnosis of renal disease prior to delivery.
• Severe peptic ulcer disease
• Severe asthma (if patient has asthma but has previously tolerated NSAIDS, she will be allowed to participate)
• Known CYP450/CY92D6 mutation conferring opioid ultra-rapid metabolizer status.
• Allergy to any of the study drugs (anaphylaxis).
• Incarcerated or institutionalized patients.
• Inability to follow up as outpatient in our outpatient clinic.
• wound dehiscence or infection diagnosed prior to discharge from the hospital
• wound vac placed prior to discharge from the hospital