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Comfortable labor with intrathecal narcotics

J Zapp1, T Thorne

  • 1Anesthesia Service, Reynolds Army Community Hospital, Fort Sill, OK 73503, USA.

Military Medicine
|May 1, 1995
PubMed
Summary
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Intrathecal narcotic injection (LIA) offers an effective and cost-saving alternative to traditional labor epidural analgesia. This method was highly accepted by patients, with 94% reporting satisfaction and willingness to repeat the procedure.

Area of Science:

  • Obstetrics and Gynecology
  • Anesthesiology
  • Pain Management

Background:

  • The U.S. Army Health Service sought high-quality labor analgesia programs.
  • Dedicated Labor Epidural Services are costly, particularly in terms of manpower.
  • An alternative to expensive labor epidural analgesia was needed.

Purpose of the Study:

  • To evaluate the effectiveness and patient acceptance of intrathecal narcotic injection (LIA) as a cost-saving alternative to labor epidural analgesia.
  • To assess pain reduction using the visual analog scale.
  • To determine long-term patient satisfaction with LIA.

Main Methods:

  • 150 laboring patients volunteered for the LIA program after reviewing patient fact sheets.
  • Intrathecal morphine (0.25 mg) and fentanyl (25 mcg) were administered once active labor began.

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  • Pain levels were assessed using the visual analog scale before and after LIA.

    • Main Results:

    • Ninety-four percent of patients reported that LIA was effective and would opt for it again.
    • Subjective patient reports at 2-week follow-up indicated high satisfaction.
    • LIA demonstrated significant pain reduction and positive patient feedback.

    Conclusions:

    • Intrathecal narcotic injection (LIA) is a well-accepted and cost-effective method for labor analgesia.
    • LIA provides a viable and highly satisfactory alternative to traditional epidural analgesia.
    • The program proved to be a successful cost-saving measure for the Army Health Service.