What narcotics are in common use in the U.S. for relieving labor pain?
What are the effects of narcotics on labor pain?
How are narcotics administered?
What are the advantages of narcotics?
What are the drawbacks of narcotics?
Narcotics (also known as opioids) popular in the U.S. include Sublimaze (fentanyl), Stadol (butorphanol), Nubain (nalbuphine), and Demerol (meperidine, also known as pethidine).
Narcotics dull pain.
Narcotics can be injected into a muscle (usually the hip) or into a port on IV (intravenous) tubing.
A new alternative is patient-controlled analgesia (PCA). With this technique, you can give yourself a small dose of IV medication when you need it by pushing a button. A lockout mechanism keeps you from going beyond a preset dose.
A nasal spray version of butorphanol (Stadol NS), which was developed to treat migraine pain, is used in some maternity settings. The manufacturer's "label" for this drug, which has been approved by the U.S. Food and Drug Administration, does not recommend use in labor as it has not been studied for this purpose.
- have a short lag time between requesting a narcotic injection and receiving it; there is no lag time with patient-controlled analgesia (PCA) once it's set up
- do not interfere with labor progress or ability to push
- can be helpful if backache between contractions prevents rest
- do not require presence of an anesthesiologist for their administration and monitoring.
- are not very effective at relieving contraction pain: in some settings, quite a few women with narcotics go on to have an epidural as well
- may confine you to bed
- can cause nausea: for this reason, another medication is often given along with narcotics to counteract this effect
- can lower your blood oxygen level: this is unlikely to be a problem in a healthy mother with a healthy, full-term infant
- can make you drowsy: the way that alcoholic beverages might
- may make it more difficult to work with contractions due to the effects they can have on mental alertness
- may result in a sleepy and unresponsive baby: baby may need resuscitation and a medication (Narcan) to reverse the effects on respiration; PCA may cause more problems in this regard depending on permissible dose and whether you are allowed to use it late in labor
- have adverse effects on newborn behavior, including breastfeeding, that last several days; this is because opioids and their breakdown products cross the placenta, and the baby's immature liver and kidneys take a long time to process them
- may increase the likelihood that the child develops addictive or self-destructive behavior patterns later in life.
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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Most recent page update: 11/16/2012