Pain management in labour

Question 1

which 2 OTC drugs are commonly used for pain relief in early labour?

Answer 1

codeine and paracetamol

Question 2

in which stage of labour do TENS machines tend to be most useful?

Answer 2

they can be useful early on in labour

Question 3

which class of OTC analgesics are avoided during labour?

Answer 3

NSAIDs

Question 4

what is the composition of entonox?

Answer 4

50% oxygen and 50% nitrous oxide

Question 5

3 AEs of entonox

Answer 5

lightheadedness

sleepiness

nausea

Question 6

which 2 opiates are given in labour? how?

Answer 6

pethidine and diamorphine

they are given by IM injection

Question 7

which drugs is given as patient-controlled analgesia in labour?

Answer 7

remifentanil

short acting opiate

Question 8

effect of opiates on

the mother

the neonate (2)

Answer 8

drowsiness

respiratory depression (especially if given too close to birth), difficulty with first feed

Question 9

which drugs are given for an epidural? (1 + 1 of 2)

Answer 9

fentanyl +

levobupivacaine or bupivacaine

Question 10

6 adverse effects/complications of an epidural

Answer 10

increased risk of an instrumental delivery
prolonged second stage
nerve injury
motor weakness
hypotension
headache after insertion

Question 11

prompts the need for an urgent anaesthetics review following an epidural

Answer 11

woman unable to straight leg raise

suggests that the spinal catheter is in the subarachnoid space i.e. they have a spinal rather than an epidural