Comparison of Pentazocine and Pethidine in Labour

Abstract

Dysuria in Women-Waters et al. IIRMM 757dysuria is commoner in women who have had children (Waters, 1969) whereas age-adjusted mean systolic and diastolic blood pressures decrease with the number of children (Miall and Oldham, 1958).Fifty-three (1-8°,') of the women seen during the initial screening survey dated their first attack of dysuria' to childhood. A oomparison of symptoms in these women ;with those who had dysuria only in adult life suggests that their symptoms are more severe and more frequent and that they are more likely to consult a doctor (Table IV). After standardizing for age there is no evidence that their plasma urea, plasma creatinine, or blood pressure is different when compared with women who have never had dysuria. There is, however, evidence of a significant impairment of renal concentrating power. Loss of renal concentrating power is one of the earliest signs of chronic pyelonephritis, and the present finding suggests that dysuria in childhood is associated with kidney damage. The fact that women who report dysuria in childhood are significantly younger than the rest of the population could be the result of a higher mortality, but more probably this trend is simply an effect of memory.Thus dysuria in women is unlikely to lead to impairment of kidney function but may be associated with higher than average blood pressure levels. In view of the large number of women with dysuria the present findings are on the whole reassuring, but they do not exclude the possibility that a few women with dysuria may develop kidney damage. There is no evidence of such a group in the numbers examined. Women with histories of dysuria in childhood, however, do show evidence of a decreased renal concentrating power, which suggests that in childhood this symptom is associated with kidney damage which persists into adult life.

Pentazocine

“…doses of 30 to 45 mg pentazocine during labour (Filler and Filler, 1966;Moore et al, 1970), and Apgar scores in infants born after the administration of pentazocine were similar to those obtained after the administration of pethidine (Duncan et al, 1969;Moore et al, 1970;Mowat et al, 1970). 1,2,3,4,S,6-hexahydro-S-hydroxy..{i-ll-dimethyl-3-(3-methylbut-2-eny1)-2,6-methano-3benzazocine 4.1 Synonyms Also known by the research code name Win20,228 and the trade names Fortalgesic, Fortral , Fortralin, Sosegon and Talwin.…”

“…Differences between the two pethidine groups, and between pethidine 100 mg and pentazocine 40 mg were not statistically significant. These workers, like Levy (1971) observed a tendency for the second dose of pentazocine to provide relief of pain in a smaller proportion of patients than the first dose, but this tendency has not been confirmed by others (Duncan et al, 1969;Mowat and Garrey, 1970). In a study involving 98 predominantly multiparous patients, O'Dwyer (1971) reported pain relief at 1 hour in 44 % of those given pentazocine 30 mg and in 54 % given a combination of pethidine 100 mg and levallorphan 1.25 mg. No significant difference in the degree of pain relief afforded by either drug was demonstrated (p > 0.05).…”

“…In 6 comparative studies involving a total of 747 patients who were more than 35 weeks pregnant, carrying a single fetus, and without pelvic abnormalities, there was no statistically significant difference in the analgesic efficacy of pethidine 100 mg and pentazocine 40 to 60 mg (County Borough of Reading Midwife Service, 1969;Levy, 1971;Mooreetal., 1970) ; pethidine < 150mgand pentazocine < 60 mg (Mowat and Garrey, 1970); pethidine 120 mg and pentazocine 48 mg (Duncan et al, 1969); or pentazocine 30 mg and pethidine 100 mg combined with levallorphan 1.25 mg (O'Dwyer, 1971) . On the other hand, Freedman et al (1967) found subcutaneous pentazocine in total dosages of 30 to 150 mg (30 to 90 mg in 92 % of women) an unsatisfactory analgesic during labour, only 22 % of patients experiencing some pain relief.…”

“…relief in about 80 %of patients in labour. Pentazocine: A Review 39 Some degree of pain relief after the first injection was reported by Mowat and Garrey (1970) in 38 % given pentazocine and in 41 % given pethidine, the analgesic effects of high doses of pentazocine being considered similar to those of lower doses. This observation was also reported by Weiss et al (1971) in a study in 150 obstetric patients given pentazocine in dosages ranging from 30 to 90 mg.…”

“…Those reported most commonly were nausea and/or vomiting , retching, drowsiness and dry mouth; side-effects occurring less frequently after the second injection than after the first. The incidence of nausea and vomiting was generally lower after pentazocine than after approximately equianalgesic dosages of pethidine (County Borough of Reading Midwife Service, 1969;Moore et al, 1970;Mowat and Garrey, 1970).…”