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Labour pain and pharmacological pain relief practice points

Background: Labour pain is the result of a complex and subjective interaction of multiple physiologic and psychosocial factors on a woman's individual interpretation of labour stimuli. Accurate measurement and appropriate management of pain is a significant problem for attendant medical and nursing personnel. There are choices to be made during pregnancy about options available for pain relief in labour; each method has its own risks and benefits, with variations in effectiveness, availability and acceptability. Aim: The aim of this review was to explore practice points for the use of pethidine and epidural in labour. Methods: A thorough literature search was conducted in different nursing and medical databases such as PubMed, Cochrane Reviews and also Google, using relevant with this review key words. Results: Pethidine has been used extensively in spinal anaesthesia and is used intramuscularly for labour analgesia. Its’ popularity is ascribed to its being until recently the only drug for pain relief included in labor ward patient group directives for midwives, and the fact that it is low cost. However, there are considerable doubts about its effectiveness and concerns about its potential maternal, fetal and neonatal side-effects. Epidural analgesia is the only consistently effective method of labor pain relief and has recently undergone substantial improvements to address the concerns of both parturient and obstetric care providers. Conclusions: Labour pain management includes a broad range of pharmacologic and no pharmacologic intervention strategies. Despite the popularity and effectiveness of pethidine and epidural analgesia it is of great importance to bare in mind the possible side-effects.

Author(s): Iliadou Maria

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