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

Elbourne, Diana; Wiseman, Richard Rew

doi:10.1002/14651858.cd001237

Cited by 21 publications

(13 citation statements)

References 32 publications

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“…This may not be surprising because this method is widely used. Worldwide, many institutions have reported a high frequency of use of systemic opioids like pethidine, pentazocine, morphine, and meperidine 4,5,34,35. Pethidine remains a common choice worldwide, despite a lack of convincing evidence for its analgesic effectiveness and safety during labor 36,37.…”

Section: Discussionmentioning

confidence: 99%

“…Treatments found to have been used at one time or another include parenteral opioids,3–5 epidural analgesia,6,7 and inhalational agents like nitrous oxide. The place of nonpharmacologic agents, like transcutaneous electrical nerve stimulation (TENS),8,9 hypnosis,10 and acupuncture11,12 to relieve labor pains has also been shown in many studies.…”

Section: Introductionmentioning

confidence: 99%

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Pain relief in labor: a survey of awareness, attitude, and practice of health care providers in Zaria, Nigeria

Ogboli-Nwasor¹,

Adaji²,

Bature³

et al. 2011

JPR

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Background:The purpose of this study was to assess the attitudes of maternal health care providers to pain relief during labor in Zaria, Nigeria.Methods:This was a multicenter, collaborative, cross-sectional pilot study of provider perspectives concerning pain relief during labor. A structured, self-administered, questionnaire was completed by 95 consenting maternal health care providers at three high-volume facilities in Zaria, an ancient northern Nigerian city. Descriptive statistics was performed on the data.Results:Most respondents (94.8%) agreed that pain relief is needed during labor. Only 2.1% of respondents were undecided about the provision of pain relief during labor and 3.2% were of the opinion that pain relief was not necessary during labor. Most respondents (93.7%) had attended a woman in labor in the 4 weeks preceding the survey. Of these, 56.8% had counseled a parturient in labor. Most of the counseling (42.1%) took place during labor. Less than half of the respondents (48.4%) had administered pain relief in labor in the preceding 4 weeks and systemic opioids was the most commonly form of pain relief. Among the respondents who did not offer pain relief agents in labor, the majority (54.5%) had no reason for not offering it. Unavailability of methods, inability to afford the cost of pain relief, lack of knowledge and skills, as well as lack of essential equipment to provide the procedure were also given by respondents as reasons for not offering pain relief.Conclusion:Even though maternal health care providers in this environment have a positive attitude to pain relief in labor, most women go through labor without the benefit of analgesia. There exists a gap between provider attitudes to pain relief in labor and practice of the same, with many providers having no genuine reason(s) for not offering pain relief to their clients during labor. Providers need to align their practice to their attitudes, and need to be helped to do this through training as well as enhancing their ability to think critically about their practice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pain relief in labor: a survey of awareness, attitude, and practice of health care providers in Zaria, Nigeria

Ogboli-Nwasor¹,

Adaji²,

Bature³

et al. 2011

JPR

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“…In a review by Elbourne and Wiseman, 16 trials were reviewed and they represented that there was no evidence of a difference between pethidine and tramadol in terms of interval to delivery, pain relief or operative delivery 16 …”

Section: Discussionmentioning

confidence: 99%

A comparison of tramadol and pethidine analgesia on the duration of labour: A randomised clinical trial

Khooshideh¹,

Shahriari

2009

Aust NZ J Obst Gynaeco

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“…Whereas intramuscular opioid injections may be unreliable, patient controlled intravenous analgesia has been used successfully in obese patients. However, opioids in labour have been associated with maternal and fetal side‐effects [86]. All these methods potentially cause maternal drowsiness and lead to airway obstruction, thus inherently carrying a risk to the obese parturients.…”

Section: Anaesthetic Managementmentioning

confidence: 99%

Obesity and obstetric anaesthesia

Saravanakumar¹,

Sg²,

2005

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Summary The prevalence of obesity continues to increase despite preventive strategies. Obese parturients are at increased risk of having either concurrent medical problems or superimposed antenatal diseases such as pre‐eclampsia and gestational diabetes. Moreover, they have a tendency to labour abnormally contributing to increased instrumental delivery and Caesarean section. Obesity is a risk factor for anaesthesia related maternal mortality. Morbidly obese women must be considered as high‐risk and deserve an anaesthetic consultation during their antenatal care. The significant difficulty in administering epidural analgesia should not preclude their use in labour. A more liberalised use of regional techniques may be a means to further reduce anaesthesia‐related maternal mortality in the obese population. The mother's life should not be jeopardised to save a compromised fetus. Prophylactic placement of an epidural catheter when not contraindicated in labouring morbidly obese women would potentially decrease anaesthetic and perinatal complications associated with attempts at emergency provision of regional or general anaesthesia. Early mobilisation, aggressive chest physiotherapy and adequate pain control are essential components of effective postoperative care.

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

Cited by 21 publications

References 32 publications

Pain relief in labor: a survey of awareness, attitude, and practice of health care providers in Zaria, Nigeria

Pain relief in labor: a survey of awareness, attitude, and practice of health care providers in Zaria, Nigeria

A comparison of tramadol and pethidine analgesia on the duration of labour: A randomised clinical trial

Obesity and obstetric anaesthesia

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