II. Preparations: Non-Opioids
-
Acetaminophen
- Dosing: 1000 mg orally every 6 hours prn
-
Diphenhydramine
- Dosing: 25-50 mg orally, IV or IM every 4-6 hours
-
Promethazine (Phenergan)
- Dosing: 25-50 mg orally or IM, 12.5 to 25 mg IV every 4-6 hours
III. Preparations: Systemic Opioids (30 minutes to 2 hours relief)
- Nalbuphine (Nubain)
- Dose: 10-20 mg IV, IM or SC every 3 hours prn
- Onset in 2-3 minutes with IV Nalbuphine and 15 minutes with IM or SQ dosing
-
Morphine
- Active Labor: 2-4 mg IV every 2-4 hours (onset in minutes)
- Latent Labor: 5-10 mg IM every 4 hours (onset in 40 minutes)
- Butorphanol (Stadol)
- IV: 1-2 mg IV every 4-6 hours prn (onset in 5-10 minutes)
- IM: 2-4 mg every 4-6 hours prn (onset in 30-60 minutes)
-
Fentanyl (Sublimaze)
- 50-100 mcg IV every hour prn (onset in minutes)
- Consider Patient Controlled Analgesia
- Fentanyl
- Alfenta
- Remifentanil (Ultiva)
- Nitrous Oxide (50/50 mix with oxygen)
- Adverse effects include Nausea, Vomiting, Dizziness
- Onset is rapid with mask application, and clears rapidly with mask removal
- Klomp (2012) Cochrane Database Syst Rev (9): CD009351 [PubMed]
IV. Preparations: Spinal Anesthesia or Neuraxial Anesthesia (3-6 hours relief)
- Indications
- Cervix dilated to 4 cm or beyond
- Options
V. Preparations: Regional Labor Anesthesia
VI. References
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Related Studies
| Definition (CSP) | state characterized by loss of feeling or sensation caused by anesthetics; depression of nerve function is induced to decrease pain during labor and childbirth. |
| Concepts | Therapeutic or Preventive Procedure (T061) |
| MSH | D000773 |
| CPT | 1003124 |
| English | Anesthesia, Obstetric, Anesthesia, Obstetrical, Obstetric Anesthesia, Obstetrical Anesthesia, anesthesia for obstetrics, anesthesia obstetrics, obstetrics anesthesia, anesthesia in obstetrics, anesthesia obstetric, obstetric anesthesia, obstetrical anesthesia, Anesthesia for Obstetric Procedures, Anesthesia in obstetrics |
| Swedish | Bedövning vid förlossning |
| Czech | anestézie porodnická |
| Finnish | Synnytysanestesia |
| Russian | ANESTEZIIA V AKUSHERSTVE, ANESTEZIIA AKUSHERSKAIA, АНЕСТЕЗИЯ АКУШЕРСКАЯ, АНЕСТЕЗИЯ В АКУШЕРСТВЕ |
| Japanese | 産科麻酔, 産科麻酔法, 麻酔-産科 |
| Croatian | ANESTEZIJA U PORODILJSTVU |
| Polish | Znieczulenie w położnictwie |
| Norwegian | Fødselsanestesi, Bedøvelse ved fødsel, Obstetrisk anestesi |
| French | Anesthésie obstétricale |
| German | Anästhesie, geburtshilfliche |
| Italian | Anestesia in ostetricia |
| Dutch | Anesthesie, obstetrische, Obstetrische anesthesie |
| Portuguese | Anestesia Obstétrica |
| Spanish | Anestesia Obstétrica |
