Non-opioid drugs for pain management in labour

Othman, Mohammad; Jones, Leanne; Neilson, James P

doi:10.1002/14651858.cd009223

Cited by 25 publications

(22 citation statements)

References 21 publications

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“…While most women receive analgesia for labour, the pain experienced by each woman is highly variable (Jones et al, 2012). This unique experience is believed to be affected by not only physiological factors, such as maternal position in labour and mobility, but also psychosocial factors, including levels of fear, anxiety or confidence (Othman et al, 2012). A systematic review undertaken to examine which method of pain relief was most efficacious to women in childbirth concluded suitability of pain relief methods needed to be tailored to each woman's circumstance, experience and expectation of labour pain (Jones et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Taking the alternative route: Women's experience of intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for labour analgesia

2017

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Section: Introductionmentioning

confidence: 99%

Taking the alternative route: Women's experience of intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for labour analgesia

2017

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“…There are few alternative pharmacological options for women, with choice limited to what is held at the different hospitals . Although research suggests that women experience superior satisfaction in pain management in labour with the use of opioids compared with non‐opioids, practitioners continue to debate which opioid and mode of administration is most effective …”

Section: Introductionmentioning

confidence: 99%

A comparison of fentanyl with pethidine for pain relief during childbirth: a randomised controlled trial

Fleet

Belan

Jones

et al. 2015

BJOG

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Objective To compare the efficacy of fentanyl administered via the subcutaneous (s.c.) or intranasal (i.n.) route with intramuscular (i.m.) pethidine in labouring women requesting analgesia.Design A randomised controlled trial three-armed, parallel-design.Setting A regional hospital and the largest tertiary maternity centre in South Australia.Sample One hundred and fifty-six healthy parturients birthing at term.Methods Women were randomised to receive s.c. fentanyl (n = 53), i.n. fentanyl (n = 52), or i.m. pethidine (n = 51). The outcomes were analysed by intention-to-treat.Main outcome measures Pain scores measured before and 30 minutes after opioid administration.Results All groups reported clinically significant reductions in pain scores (mean range 1.2-1.6; P < 0.001), with no significant differences between groups. Significantly more women in the fentanyl groups reported satisfaction with using the study drug again, compared with women receiving i.m. pethidine (82.9% i.n. fentanyl, 80.6% s.c. fentanyl, and 44.0% i.m. pethidine; P < 0.01). Women in the fentanyl groups experienced less sedation (i.n. fentanyl 7.3%, s.c. fentanyl 2.9%, i.m. pethidine 44%; P ≤ 0.03), shorter labours by at least 2 hours (P < 0.05), and fewer difficulties establishing breastfeeding (78.8% i.m. pethidine, 39.4% i.n. fentanyl, and 44.0% s.c. fentanyl; P < 0.01). Neonates in the pethidine group were more likely to require nursery admission (P < 0.02).Conclusions Fentanyl administered by s.c. and i.n. routes is as efficacious in relieving labour pain as i.m. pethidine, but resulted in greater satisfaction, less sedation, shorter labour, fewer nursery admissions, and fewer difficulties in establishing breastfeeding. Fentanyl appears to be a suitable alternative to pethidine when providing parenteral pain relief to labouring women.Keywords Fentanyl, intramuscular, intranasal, labour, pethidine, subcutaneous.Please cite this paper as: Fleet J, Belan I, Jones MJ, Ullah S, Cyna AM. A comparison of fentanyl with pethidine for pain relief during childbirth: a randomised controlled trial. BJOG 2015;122:983-992.

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“…Paracetamol hepatotoxicity is, however, one of the top causes of acute fulminant liver failure in young individuals worldwide and is a potential maternal concern. Paracetamol offers better pain relief and satisfaction with the childbirth experience than placebo …”

Section: Pharmacological Methodsmentioning

confidence: 99%