Using Narcotics for Pain Relief During Childbirth

Fentanyl: Fentanyl is a synthetic narcotic similar to Morphine or Demerol and provides moderate to mild sedation. The advantages of using Fentanyl include:

  • Begins working quickly, (but only lasts usually 20-30 minutes)
  • Minimal sedation
  • Nausea
  • Minimal fetal effects

Intrathecal Fentanyl is the placement of fentanyl, into the fluid surrounding the spinal cord. This is different from an epidural in which medication is placed into the epidural space. Intrathecal Fentanyl is a one-time injection into the spinal column similar to an epidural.

How can Fentanyl affect my baby or myself?
You and your baby may experience some sedation and/or nausea. According to Danforth’s Obstetrics and Gynecology 9th edition, baby’s born to mothers who used Fentanyl to relieve pain during labor were less likely to need Narcan (medication to help with breathing) then babies born to mothers who used Demerol during childbirth

How will my pain medication be given?

Medication can be given in any of the following ways:

  • A one time injection into the spinal column
  • IV or “Intravenous” placement into a vein on the back of the hand or arm. A needle is inserted into a vein with a plastic tube connected to a bag holding fluid that slowly drips into your body. An IV is typically placed to help you stay hydrated throughout labor and assures access for the administration of medications as they are needed.
  • Patient Controlled Analgesia (PCA) pump is way a mother can control when she receives pain mediation during labor by pushing a button. The advantage of having a PCA is that it provides a sense of control and the mother does not have to wait for the nurse to bring pain medication. Fentanyl, Remifentanil (a narcotic that is too new for long term studies on side effects), and Demerol are common narcotics that can be given through a PCA pump. The pump is pre-programmed based on the drug dosage into amounts small enough to relieve pain without releasing too much medication.

Reprinted with permission from American Pregnancy Association

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