Labor & Delivery

Labour Analgesia: The Role of Pethidine

Labour Analgesia: The Role of Pethidine

Introduction

Childbirth is a significant milestone in a woman’s life, often accompanied by intense pain. Managing this pain effectively is essential for a positive birth experience. Pethidine, also known as meperidine, is one of the pharmacological options available for pain relief during labour. This article explores the use, benefits, effectiveness, and considerations of pethidine in labour analgesia.



What is Pethidine?

Pethidine is a synthetic opioid analgesic that helps manage moderate to severe pain by binding to opioid receptors in the brain and spinal cord. This alters the perception of pain and emotional response to it. In labour, pethidine is administered to provide pain relief and help the mother relax.



Administration and Dosage

Pethidine is administered via intramuscular injection. It takes about 30 minutes to start working, and its effects typically last between 3 to 4 hours. This duration makes it suitable for use during the early and active stages of labour.



Effectiveness of Pethidine in Labour

Pethidine can provide effective pain relief for some women during labour. It primarily works by reducing anxiety and creating a feeling of distance from the pain and the overall labour experience, rather than eliminating the pain entirely. Some women find this to be a significant relief, making the experience more tolerable.



Benefits of Pethidine in Labour

  1. Effective Pain Relief: Pethidine effectively alleviates labour pain, making the experience more tolerable.
  2. Sedative Effect: It has a sedative effect, which helps the mother relax and conserve energy during labour.
  3. Ease of Administration: Pethidine can be administered easily by healthcare professionals without the need for specialized equipment.
  4. Flexibility: The dosage can be adjusted based on the mother’s pain levels and progress in labour.



In Combination With

Pethidine can be used in combination with Entonox (also known as gas and air) to enhance pain relief during labour. This combination can provide additional comfort and pain management.



Considerations and Contraindications

While pethidine offers significant benefits, there are important considerations and potential contraindications to be aware of:

  1. Maternal Side Effects: Common side effects include nausea, vomiting, dizziness, and drowsiness. In some cases, it can cause respiratory depression.
  2. Neonatal Effects: Pethidine crosses the placenta and can affect the baby, leading to respiratory depression, drowsiness, and difficulty initiating breastfeeding. These effects are more pronounced if the drug is administered close to delivery.
  3. Contraindications: Pethidine should be avoided if you have epilepsy or a known allergy to pethidine.
  4. Limited Duration: The pain relief provided by pethidine is temporary, and repeat doses may be required, increasing the risk of side effects.
  5. Impact on Labour: Pethidine can sometimes slow down labour progress by reducing uterine contractions, although this is not always the case.



Side Effects

Pethidine and other opioids can cause several side effects, including:

  • Drowsiness: Feeling very sleepy
  • Nausea and Vomiting: Feeling or being sick
  • Delayed Digestion: Opioids delay the digestion of food, which may result in a fuller stomach
  • Neonatal Effects: If administered close to delivery, pethidine may affect the baby’s breathing. The baby might also be drowsy and slow to feed
  • Combination with Entonox: Women who use opioids like pethidine often continue using Entonox as well for additional pain relief



Alternatives to Pethidine

Given the potential side effects, some women and healthcare providers may opt for alternative pain relief methods, such as:

  1. Epidural Analgesia: Provides more comprehensive pain relief but requires an anaesthetist and continuous monitoring.
  2. Nitrous Oxide: Offers mild pain relief with minimal side effects, but may not be sufficient for all women.
  3. Non-Pharmacological Methods: Techniques such as breathing exercises, water immersion, and massage can be effective in managing pain without the risk of side effects.



Conclusion

Pethidine remains a widely used option for labour analgesia due to its effectiveness and ease of administration. However, its use should be carefully considered, weighing the benefits against potential risks for both the mother and baby. Open communication between the mother and her healthcare team is essential to making informed decisions about pain management during labour. By understanding the options available, including pethidine, expectant mothers can approach childbirth with confidence and a sense of control over their pain relief choices.



Message to Patients from Dr. Bushra Gul



Dear Patients,



I am dedicated to providing you with the best care and support during your labour and delivery. The use of pethidine can offer significant benefits in terms of comfort and pain relief. If you are considering this option, please discuss it with your healthcare team to determine what is best for you and your baby.