Types of intra-muscular opioids for maternal pain relief in labour

Abstract

The editorial group responsible for this previously published document have withdrawn it from publication.

The effect of local anaesthetic on post-operative pain with wound instillation via a catheter for paediatric orthopaedic extremity surgery

“…We think that this was due to the early need for additional analgesic requirement in this group and, thus, increased opioid consumption. Several studies have determined varying rates of nausea and vomiting after the administration of meperidine [33,34].…”

Prescribing intramuscular opioids for labour analgesia in consultant-led maternity units: a survey of UK practice

“…Our survey has shown that intramuscular pethidine is still used widely in consultant-led units (84.4% of units) despite research demonstrating its lack of efficacy as an analgesic and its adverse effects on both mother and neonate. [3][4][5][6][7]11,13,14 Since 1968 midwives have also been able to administer diamorphine via the exemption list (1968 Medicines Act). The results of one Scottish study, 9 and anecdotal evidence relating to improved analgesia with fewer side effects, have led to a renewed interest in its use.…”

“…It was noted that the dose regimens and intervals for different opioids were not related to the duration of action of the individual drugs or comparative potencies and this may have an effect on the efficacy of analgesia. 5,6,[15][16][17][18][19] This may reflect, in part, the lack of published data to suggest the most effective opioid and dosing regimen. 5,6 The dose for optimal maternal analgesia may cause excessive neonatal sedation.…”

“…5,6,[15][16][17][18][19] This may reflect, in part, the lack of published data to suggest the most effective opioid and dosing regimen. 5,6 The dose for optimal maternal analgesia may cause excessive neonatal sedation. 20 This effect is influenced not only by the maternal opioid dose but also by the dose-delivery interval.…”

“…There are considerable doubts about the analgesic efficacy of pethidine and concerns about the side effects in mother, fetus and neonate. [2][3][4][5][6][7] Pethidine has the advantages of ease of administration, familiarity and low cost. A more recent report by the CRAG Working Group on Maternity Services (1996) showed that diamorphine had overtaken pethidine as the most popular intramuscular analgesic in labour in Scotland in all types of unit.…”