ALERT!!: A Nationwide Shortage of Pain Medication for Labor Pain Grows


A MAJOR MEDICATION SHORTAGE IS RAISING CONCERNS ABOUT THE ABILITY TO PROVIDE COMFORT AND SAFETY FOR WOMEN IN LABOR. I’M DR. JAMES LOZADA. DOCTORS AROUND THE COUNTRY ARE COUNTING THE VIALS OF LOCAL ANESTHETIC TO SEE HOW MUCH THEY HAVE BEFORE RUNNING OUT. THE DRUG—CALLED BUPIVACAINE—IS USED TO PROVIDE ANESTHESIA FOR CESAREAN DELIVERIES AND LABOR EPIDURALS. FOR CESAREAN DELIVERIES AND LABOR EPIDURALS. A CRITICAL SHORTAGE HAS EMERGED—DUE TO MANUFACTURING DELAYS. THIS DRUG IS ESPECIALLY IMPORTANT IN OBSTETRICS—BECAUSE IT ALLOWS ANESTHESIOLOGISTS TO AVOID GENERAL ANESTHESIA AND PROVIDE PAIN RELIEF USING SPINAL ANESTHESIA. STUDIES SHOW GENERAL ANESTHESIA FOR CESAREAN DELIVERY IS ASSOCIATED WITH INCREASED ADVERSE OUTCOMES FOR BOTH MOTHER AND BABY. I DON’T THINK WOMEN SHOULD BE CONCERNED YET. BUT WE DID WANT TO HAVE THE MEDICAL COMMUNITY AWARE THAT CONTINGENCY PLANS NEED TO OCCUR. LET’S LOOK AT HOW SHORTAGES LOOK ACROSS THE U.S. BRIGHT RED MEANS SHORTER SUPPLY. IN SAN FRANCISCO, ONE HOSPITAL REPORTS ONLY FOUR DAYS. A HOSPITAL IN HOUSTON–14 DAYS. CHICAGO–21 DAYS. PITTSBURGH–21 DAYS. AND A HOSPITAL IN NEW YORK–21 DAYS. THIS IS ALSO AFFECTING CANADA. NOVA SCOTIA HAS 28 DAYS REMAINING. AND SHORTAGES ARE ALSO REPORTED IN ONTARIO, QUEBEC AND BRITISH COLUMBIA. ON SOCIAL MEDIA—ANESTHESIOLOGISTS ARE TALKING ABOUT PREPARATION AND RESPONSE. AND SOAP—THE SOCIETY FOR OBSTETRIC ANESTHESIOLOGY AND PERINATOLOGY—IS OUT WITH AN ADVISORY ON THE SHORTAGE. IT IS IMPORTANT THAT WE ARE ABLE TO GIVE THE SAFEST WITH THE MOST RAPID ONSET AND THE MOST PREDICTABLE ANESTHETIC. NOW IF WE DON’T HAVE THESE SOLUTIONS, WE MAY NEED TO RESORT TO ALTERNATIVES THAT MAY NOT PROIVDE THE SAME EFFICACY AND SAFETY. I REACHED OUT FRIDAY TO PFIZER—ONE OF THE MAIN MANUFACTURERS OF BUPIVACAINE. THEY SAID THAT THIS SHORTAGE MOSTLY AFFECTS THE U.S. MARKET. AND IN A STATEMENT, SAID: MOSTLY AFFECTS THE U.S. MARKET. AND IN A STATEMENT, SAID: THE PFIZER DELAY IS ALSO IMPACTING OTHER COMPANIES. THE PFIZER DELAY IS ALSO IMPACTING OTHER COMPANIES. TWO OTHERS HAVE BEEN UNABLE TO KEEP UP WITH INCREASED BUPIVACAINE DEMAND. THE SHORTAGE EXTENDS TO ALL STRENGTHS OF BUPIVICAINE AND EVEN INCLUDES OTHER LOCAL ANESTHETICS. AND THERE’S NO CLEAR RESOLUTION IN SIGHT. SO DOCTORS AND PHARMACISTS ARE MAKING CONTINGENCY PLANS AND PREPARING FOR WHAT COULD BE A LONG-TERM SHORTAGE. I’M DR. JAMES LOZADA.