Labor Sedation

Aka: Labor Sedation, Latent Labor Anesthesia

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II. Preparations: Intrapartum Analgesia (Use with sedation medications)

  1. Morphine Sulfate
    1. Intravenous: 2-4 mg
    2. Intramuscular: 10-15 mg
  2. Meperidine (Demerol)
    1. Dosing
      1. Intravenous: 25-50 mg
      2. Intramuscular: 50-75 mg
    2. Precautions: Not recommended
      1. No benefits in First Stage of Labor
      2. Associated with higher rate of Newborn Distress
      3. Sosa (2004) Am J Obstet Gynecol 191:1212-8 [PubMed]

III. Preparations: Sedation in latent phase: Phenothiazine

  1. General
    1. Less risk of neonatal depression except high dose
  2. Preparations
    1. Hydroxyzine (Vistaril)
      1. Oral: 100 mg PO qhs prn
      2. Intramuscular: 50-100 mg
      3. Intravenous: 50 mg IV
    2. Promethazine (Phenergan)
      1. Oral, Intramuscular, or rectally: 25 to 50 mg
      2. Intravenous (not FDA approved): 12.5 to 25 mg

IV. Preparations: Sedation in latent phase: Barbiturates

  1. Not recommended
  2. Secobarbital (Seconal) 100 mg PO or IM
    1. Risk of neonatal depression (potentiated by Opioid)
    2. No known Antagonist

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