A Kuopio-based study provided oxycodone dosage recommendations for mothers in labour and for premature infants
A mother giving birth may need pain relief even before going into full labour.
“This is being increasingly acknowledged. Early-stage pain management helps the mother to rest and save energy for the actual delivery,” says Merja Kokki, Professor of Anaesthesiology.
Her research group has shown that oxycodone can safely be used to manage early labour pains. Oxycodone is a strong analgesic in the opioid family, and its use in labour had not been studied extensively before. Thanks to growing research evidence, oxycodone has replaced the opioid analgesic pethidine, which was previously commonly used for early labour pains, and which carries a higher risk of adverse effects for the newborn.
“Based on our studies, we have been able to provide oxycodone dosage recommendations for both mothers in labour and for the smallest premature infants who need pain relief in intensive care, for example.”
The research group has also shown that epidurally administered oxycodone relieves postoperative pain more effectively and with fewer side effects than when administered intravenously.
Paying attention to the quality of recovery
Merja Kokki was appointed as a part-time (50%) Professor of Anaesthesiology at the University of Eastern Finland in early November. She is also the Chief Physician of the Anaesthesiology and Intensive Care Department at Kuopio University Hospital.
“The professorship provides me with an opportunity to delve deeper into research. I am also eager to develop the teaching of anaesthesiology for medical students and especially for specialising physicians,” Kokki says.
Anaesthesiologists are responsible for pain management, for general and local anaesthesia, and for monitoring patients’ vital signs during various procedures. They are also responsible for pain and nausea management immediately after surgery.
“The field has evolved rapidly to meet the demands of, for example, laparoscopic surgery and short-term postoperative care.”
“Increasing attention is being paid to the quality of recovery. Early mobilisation and discharge as soon as possible after surgery promote recovery and reduce not only pain but also the risk of blood clots and infections.”
Together with pharmaceutical researchers, Kokki has studied various analgesics and prepared recommendations for their use especially in vulnerable patient groups. Her more recent studies also examine recovery and pain after cardiac surgeries and soft tissue surgeries, such as gallbladder and hernia surgeries, and gynaecological procedures.
“Even from the viewpoint of how Finland’s well-being services counties operate, it is increasingly important to study the effectiveness of care, and we are looking for new partners to do this with. Our perspective is much broader than that of anaesthesiology alone, as for example increasing sedentariness, obesity and mental health issues also affect the benefits obtained from surgeries."
Pain should be treated
“The patient is the expert on their own pain, be it labour pain or postoperative pain. Pain relief is sought to be tailored to the individual needs of the patient,” Kokki says.
Nowadays, the toolbox for relieving labour pain is quite extensive, including both local anaesthetics and non-medical treatments.
“Pain management does not remove all sense of pain, and it also guides the mother to push, for example.”
Some mothers in labour do not need, or want, pain relief. According to Kokki, that is something that should not be decided in advance, but in the moment.
“Refusing pain relief can even be harmful, for example, if the baby is premature and thus more susceptible to the stress of childbirth. It is also known that severe acute pain can predispose to prolonged pain and hinder bonding with the baby after birth.”
Labour is a challenging topic of research, as it is a sensitive family matter that can progress unpredictably.
“However, we find it important to study our local population to generate knowledge that can be applied here, locally.”
Kokki’s research group has also examined the behaviour of common anti-inflammatory drugs and paracetamol in children’s bodies during surgery. These drugs are well absorbed into the central nervous system, but even with the fastest administration method, i.e., intravenously, there is a delay, so the drug should be administered as soon as the child feels pain.
Merja Kokki
Professor of Anaesthesiology, University of Eastern Finland, 1 November 2024–
- Lic. Med., University of Oulu, 1993
- Specialist in Anaesthesiology and Intensive Care, 2007
- PhD, University of Helsinki, 2007
- Docent in Anaesthesiology and Intensive Care, University of Eastern Finland, 2013
Key roles:
- Chief Physician, Kuopio University Hospital, 2016–
- Deputy Chief Physician, Kuopio University Hospital, 2013–2015
- Anaesthesiologist, Oulu University Hospital, 2015–2016
- Clinical Researcher, University of Eastern Finland and Kuopio University Hospital, periods in 2011–2015 and in 2017
- Anaesthesiologist, Kuopio University Hospital, 2003–2010
For further information, please contact:
Professor Merja Kokki, merja.kokki@pshyvinvointialue.fi
