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Intrathecal narcotics for labor analgesia
1Naval Hospital, San Diego, California, USA.
Intrathecal narcotics are a relatively recent addition to the list of analgesic options that are available for the management of labor pain. Pain during the first stage of labor is related to repetitive uterine contractions and resultant cervical dilatation, while pain during the second stage is due to stretching of the perineum. Traditionally, continuous epidural analgesia has been used as the reference standard for providing comfort during labor. Intrathecal narcotics represent a safe and effective alternative that provides significant, rapid relief of labor pain during the first stage of labor. The drugs most often used for intrathecal administration include sufentanil, fentanyl, meperidine and morphine. Use of intrathecal narcotics does not significantly affect the natural progression of labor, and no adverse fetal outcomes have been reported.
Intrathecal narcotics are a relatively recent addition to the list of analgesic options that are available for the management of labor pain. Pain during the first stage of labor is related to repetitive uterine contractions and resultant cervical dilatation, while pain during the second stage is due to stretching of the perineum. Traditionally, continuous epidural analgesia has been used as the reference standard for providing comfort during labor. Intrathecal narcotics represent a safe and effective alternative that provides significant, rapid relief of labor pain during the first stage of labor. The drugs most often used for intrathecal administration include sufentanil, fentanyl, meperidine and morphine. Use of intrathecal narcotics does not significantly affect the natural progression of labor, and no adverse fetal outcomes have been reported.
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