Pain management for labour and delivery

Question 1

Analgesics techniques

Answer 1

Pharmacological:

• volatile agents
• nitrous oxide
• systemic opioids: pethidine, morphine, fentanyl, PCA Remifentanil

Regional techniques:

• paracervical block, pudenal block, paravertebral block
• neuraxial analgesia
• epidural, combined spinal epidural

Question 2

Systemic opioids

Answer 2

Morphine widely used in labour:

Doesn’t actually provide good pain relief in labour

Question 3

Effectiveness of epidural analgesia

Answer 3

Completely: 80%
Partially: 15%
Ineffective: 5%

Question 4

Indications for epidural

Answer 4

Maternal

- pain relief, hypertenstion (pre-eclampsia), decrease stress response