Obstetrics Book


Labor Sedation

Aka: Labor Sedation, Latent Labor Anesthesia
  1. See Also
    1. Active Labor Anesthesia
    2. Non-Pharmacologic Pain Control in Labor
    3. Epidural Anesthesia
    4. Intrathecal Morphine
    5. Paracervical Block
    6. Pudendal Block
  2. 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]
  3. 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
  4. 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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