Is Pethidine Safe during Labor? Systematic Review

Nunes, Rogevando Rodrigues; Colares, Paulo Giordano Baima; Montenegro, Juliana Pinto

doi:10.1055/s-0037-1604065

Cited by 9 publications

(8 citation statements)

References 28 publications

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“…Like our study, other studies have reported the use of pethidine and Phenergan as analgesics in various African countries, which include Egypt [ 26 ], Ghana [ 27 ], Ethiopia [ 24 , 28 ], and Nigeria [ 29 ]. The use of pethidine during labour, either intramuscularly (IM) or intravenously (IV), at low doses of up to 50 mg has been shown to be safe for the foetus, and its administration to women during childbirth has been associated with Apgar scores of 7 or higher, normal pH and arterial blood gases in infants, and no respiratory depression [ 30 ]. Clearly, the drug’s risk is dependent on its route of administration and dosage; therefore, the risk-benefit ratio of administering pethidine to women in labour should be considered [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…The use of pethidine during labour, either intramuscularly (IM) or intravenously (IV), at low doses of up to 50 mg has been shown to be safe for the foetus, and its administration to women during childbirth has been associated with Apgar scores of 7 or higher, normal pH and arterial blood gases in infants, and no respiratory depression [ 30 ]. Clearly, the drug’s risk is dependent on its route of administration and dosage; therefore, the risk-benefit ratio of administering pethidine to women in labour should be considered [ 30 ]. Nonetheless, the of analgesics treatments may occasionally be ineffective in providing pain relief for all birthing moms following their administration; they are also prone to side effects for both the mother and the infant, and they might disrupt the progress of labour.…”

Section: Discussionmentioning

confidence: 99%

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Pharmacological labour pain interventions: South African midwives’ perspective

Parkies,

Murray,

Okafor

2024

BMC Nurs

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Background Women of childbearing age feel great about giving birth, but the pain could be excruciating depending on their pain tolerances. Midwives requires obstetrical knowledge and skills such as pain management during labour and safety. We explored midwives’ perspectives on the utilisation of pharmacological pain alleviation interventions during labour in selected hospitals in Matjhabeng Municipality, Free State province, South Africa. A qualitative study was undertaken, involving a sample of ten midwives, using a semi-structured interview guide. The interviews were audio-recorded and transcribed verbatim. Tesch’s open coding data analysis method was applied to analyse the data. The midwives were restricted to use Pethidine and Phenergan prescribed by doctors for labour pain relief, which disrupted labour pain management and obliged them either to wait for a physician or follow telephone instructions. According to the midwives, women taking Pethidine and Phenergan encountered adverse effects and discomfort. Midwives identified high workload, inadequate personnel, lack of skill and knowledge, lack of medication availability, and lack of infrastructure as the primary challenges of administering pharmacological methods to women in labour. The lack of standing orders, which delays the administration of medications pending a physician’s prescription, constituted an additional difficulty. In the instance that Pethidine and Phenergan were unavailable or ineffective for some women, the midwives recommended that women be administered alternative pharmacological pain relievers. They also advocated for institutionalization of pharmacological guidelines allowing them to use their discretion when treating labour pain. Midwives can only utilise a few standardised and regulated pharmacological medications for labour pain management. The midwives’ ability to administer pharmacological pain relief during labour was hampered by a high workload burden, insufficient staff, lack of skill and understanding, drug unavailability, and inadequate infrastructure. Midwives advocated for supported guidelines that would allow them to treat labour pain at their discretion. Intersectoral stakeholders are required to improve midwife skills and attitudes. Health facilities need to train and supply analgesics to midwives. Midwives ought to be familiar with pharmacological pain relievers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pharmacological labour pain interventions: South African midwives’ perspective

Parkies,

Murray,

Okafor

2024

BMC Nurs

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“…A systemic review concludes that IM) or IV pethidine at low doses, of up to 50 mg, is safe to administer during labor. It can be given intermittently as doses of 25–50 mg IV, with an onset of action of 5–10 min and duration of 2–3 h [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…A study in Nezerland recommends that pethidine use be discouraged in favor of other opioids due to the risk of toxicity from the accumulation of the metabolite norpethidine and associated neuro excitatory effects [ 16 ], while another research concludes that pethidine remains popular in many obstetric units, is easy to administer and useful analgesic modality [ 17 ],which is supported by high level evidences that intramuscular (IM) or intravenous (IV) pethidine at low doses, of up to 50 mg, is safe to administer during labor [ [18] , [19] , [20] ].…”

Section: Methodsmentioning

confidence: 99%

Pharmacologic and non-pharmacologic labor pain management techniques in a resource-limited setting: A systematic review

Beyable

Bayable

Ashebir

2022

Annals of Medicine &Amp; Surgery

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Background Despite improvement in pain management programs, labor pain is mostly ignored especially in low and middle-income countries. Methods The aim of this study is to establish a clear clinical working guideline for labor pain management in resource limited settings. This systematic review is conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline 2020. After formulating clear criteria for the evidences to be included an appropriate method of searching was conducted by using the Pub Med, Google scholar and Cochrane library using the following MeSH terms: (‘Parenteral opioids’ AND′ Labor pain’, ‘Labor’ AND ‘Pain management, ‘Non-pharmacologic methods ‘AND ‘Labor pain’, ‘Labor pain management AND massage therapy ). The study quality of literatures was categorized based on WHO 2011 level of evidence and degree of recommendation. Final conclusions and recommendations are done with the analysis of risk and benefits of alternative management strategies for non-regional techniques of labor pain management. The study is registered with research registry unique identifying number (UIN) of 1267 “ https://www.researchregistry.com/browse-the-registry#registryofsystematicreviewsmeta-analyses/ .” and the study is moderate based on AMSTAR 2 quality assessment criteria/ https://amstar.ca/Amstar_Checklist.php . Discussion Combined forms of Non-pharmacologic and selected low dose pharmacologic approaches of labor pain management, provides significant benefits to women and their infants. During provision of labor analgesia complications may happen and the service provider should involve in the management of those complications. Conclusion This study has a paramount importance to practice the most reliable, available and cost effective method of labor analgesia.

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“…More recently, a Brazilian systematic review of international studies concluded that pethidine was safe for the infant when administered at a dose of 50mg or less (Nunes, Colares & Montenegro, 2017).…”

Section: C) Analgesicsmentioning

confidence: 99%

The Influence of Maternal Childbirth Experience on Early Infant Behavioural Style

Power¹

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The use of interventions during childbirth is increasing (WHO, 2018) and, while such interventions can be life-saving, they may have a negative impact on the mother’s experience of birth and her psychological wellbeing post birth. They may also adversely affect the newborn infant’s physiology and behaviour (Taylor, Swift & Glover, 2000; Gitau et al., 2001; Douglas & Hill, 2013). However, little is known about whether the birth and early postnatal experiences influence infant behavioural style (known as temperament) (Thomas & Chess, 1977) beyond the initial postnatal period. Employing an exploratory mixed methods approach, the overarching aim of this thesis was to explore how any potential impacts of birth experience on newborn infant behaviours may occur, and if so, whether they persist beyond the neonatal period; as well, to explore how the mother’s response to her birth experience might mediate such effects. Part One involved a qualitative exploration of the experiences and beliefs of eighteen health professionals and twenty-two mothers in relation to childbirth and early infant behavioural style. Health professionals interviewed in Study One believed that the birth experience could have a direct impact on newborn wellbeing and behaviour as well as influencing it indirectly via the mother’s response to the birth and her subsequent perceptions of and interactions with her baby. In contrast, most of the mothers interviewed in Study Two did not perceive any association between their birth experience and their baby’s early behavioural style. However, a simple content analysis highlighted strong patterns in the data between reported maternal physical and emotional birth experiences and perceived infant temperament during the first year. Part Two (Study Three) involved a detailed online survey of approximately a thousand mothers, employing quantitative methods of analysis. Although physical birth factors contributed to the newborn baby’s response (e.g. alert-content or cry-fuss behaviours), it was subjective and psychological birth factors that predicted ongoing infant behavioural style (0-6 months), for example alert-responsive or unsettled, irritable infant behaviours. Taken together, the data suggest that subjective and psychological factors could be as important as objective physical factors in post-birth mother-infant wellbeing and developing infant temperament. These findings may have important implications for future maternity and perinatal care of mothers and their infants.

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Is Pethidine Safe during Labor? Systematic Review

Cited by 9 publications

References 28 publications

Pharmacological labour pain interventions: South African midwives’ perspective

Pharmacological labour pain interventions: South African midwives’ perspective

Pharmacologic and non-pharmacologic labor pain management techniques in a resource-limited setting: A systematic review

The Influence of Maternal Childbirth Experience on Early Infant Behavioural Style

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