What type of pain med in labor used? - page 3

After attending an all day pain conference, I learned that what we are using on our unit is "old school" thought. We use Stadol and Fentanyl. I understand from this conference that Stadol is a bad... Read More

  1. by   CA CoCoRN
    I work with a majority Hispanic population and as a result, our epidural rate is LOW. Maybe 10-15 percent. A lot of those epidurals are "conversions": the pt converts their thinking that an epidural is bad to 'epidural is good, want epidural NOW!!!...'
    We get so many patients who's mother's aunt's sister-in-law's brother's wife said that the epidural was a bad thing (or old wive's tales about pain meds).....and so, try as we might to re-educate this population....sometimes it's all for naught.

    Anyway...our drug of choice is Stadol and Phenergan. 1-2 mg IVP with 12.5-25 mg IVP, respectively. One doctor likes Demerol 25 mg with Phenergan 25 mg IVP. I've not seen that combo relieve labor pain suitably in any pt.
  2. by   bbnurse
    So WHAT did the Pain seminar suggest as the best analgesia meds for active labors???
    We use Stadol and Phenergan combo and epidurals or intrathecals with fentanyl.
    Did you answer this thought or did I just flat miss it?
    Thanks.
  3. by   babyktchr
    We had an elderly patient react to phenergan IV so our policy changed to diluting it in 10-20 cc. We now just put it in a 50cc mini bag and run it in over a half hour. We don't use it so much anymore because of that....sometimes though...it is used, but in that way.
  4. by   DarC.RN
    Quote from Daynamyte
    After attending an all day pain conference, I learned that what we are using on our unit is "old school" thought. We use Stadol and Fentanyl. I understand from this conference that Stadol is a bad choice. I would just like to know what other hospitals are using as the main meds for pain in labor. Can anyone respond?
    I do not work in L&D, but have had five babies! The first three were natural (not by choice), but the last two I had Nubain, I loved it, I told my husband I wanted another child just for the Nubain (he didn't fall for it!). When my ex-husband's wife was in labor with their child I told him about nubain and he said not only did it work during labor, but she had a c-section and it worked for the pain after, I always say if it comes in a pill form I would be in trouble.
    I hope this helps, I always wanted to be a L&D nurse, but during my clinicals I had seen a 12 year old having a baby, and a women who gave birth to a baby who tested positive for crack cocaine and she signed herself out of the hospital so she could get high, and that was my first day, afterwards I decided to stay away from L&D, it can be too sad.
  5. by   SmilingBluEyes
    Yes L and D is not all hearts and flowers, the way some think.......
  6. by   lauriesalRNC
    We give Stadol or epidurals. I personally dont like Stadol that much, it does nothing for the pain and just makes the patient totally stoned. I think over 90% of our patients get epidurals though. We use the Stadol for early labor.... I think we should consider something else though.

    Quote from BabyRN2Be
    About 95% of the time, epidurals are used for pain.

    If a pt doesn't want an epidural, stadol is used most of the time.

    I've seen hypnosis do some pretty incredible stuff. I'd like to study hypnobirthing more, but both parents need to be willing to practice.
  7. by   lucky4timesover
    I am only a student nurse, but I have three children. The first one I had completely natural, the second one the doctor gace Nubain (medication from hades in my opinion it made me feel like I was high as a kite), and the doc gave me Dem for the third. In my opinion, the pain relievers didn't really do anything, it still hurt and I didn't feel I was as effective in labor.
  8. by   FrumDoula
    Is anyone using sterile water injections (known to be REALLY effective for back labor from an OP baby) or TENS? While I know these aren't medications per se, they can be very effective for pain relief.

    Hearing about 98% epidural rates saddens me ..... The side effects can be very real, and many women think they're harmless.

    Ah well, get me off my soapbox!

    Alison
  9. by   palesarah
    Quote from FrumDoula
    Is anyone using sterile water injections (known to be REALLY effective for back labor from an OP baby) or TENS? While I know these aren't medications per se, they can be very effective for pain relief.

    Hearing about 98% epidural rates saddens me ..... The side effects can be very real, and many women think they're harmless.

    Ah well, get me off my soapbox!

    Alison
    A few of our midwives do sterile water injections, and they are very effective for some patients.
  10. by   maxienurse
    Quote from Dawn27
    I know this was discussed before but I thought I'd add here too. In the UK one really popular method of pain relief is Entonox - nitrous oxide and oxygen, it seems it isn't really used at all in the US for pain relief in labour.
    I have used it personally and have lost count of the times I have looked after women who were using it.
    Entonox is Great Stuff !!!
    It is used in South Africa as well.
    I have been in the states for 4yrs now and no-one seems to know much about it at all.
    I pesrsonally had it for my births and used it widely in practice.
    Epidurals are the most popular choice nowadays and then "Pethidine" equivalent to Demerol together with Phenergan.
  11. by   greenivy
    Quote from FrumDoula
    Is anyone using sterile water injections (known to be REALLY effective for back labor from an OP baby) or TENS? While I know these aren't medications per se, they can be very effective for pain relief.

    Hearing about 98% epidural rates saddens me ..... The side effects can be very real, and many women think they're harmless.

    Ah well, get me off my soapbox!

    Alison


    Thank you!!!!!!!!

    I am concerned that my pro natural birth stance is going to bite me in the a$$ when I start nursing clinicals (in May). I've had two babies naturally and believe in what the female body is capable of. I was soooo adamant about not having drugs (and nurses coming into my room repeatedly pushing meds) that I didn't let anyone know how strong my contractions were until I was dilated to 9 (!). I felt badly that I scared one of the nurses but they were less than enthusiastic about listening to my wishes. I had an easy delivery with no drugs and a fast recovery.
  12. by   lauriesalRNC
    I see what you're saying but everyone has a choice what they want to do... these days with the epidural people I think just feel like if they dont have to be in pain then why be in pain. Yes epidurals can cause some problems BUT I think that they are relatively safe, and SAFER than IV narcotics in my opinion. I always support the patients wishes whatever they may be... if someone wants meds I just educate them on pros and cons so they know what they are getting... but never try to talk them out of it. It;s their labor, their body.


    Quote from greenivy
    Thank you!!!!!!!!

    I am concerned that my pro natural birth stance is going to bite me in the a$$ when I start nursing clinicals (in May). I've had two babies naturally and believe in what the female body is capable of. I was soooo adamant about not having drugs (and nurses coming into my room repeatedly pushing meds) that I didn't let anyone know how strong my contractions were until I was dilated to 9 (!). I felt badly that I scared one of the nurses but they were less than enthusiastic about listening to my wishes. I had an easy delivery with no drugs and a fast recovery.
  13. by   greenivy
    Quote from lauriesalRNC
    I see what you're saying but everyone has a choice what they want to do... these days with the epidural people I think just feel like if they dont have to be in pain then why be in pain. Yes epidurals can cause some problems BUT I think that they are relatively safe, and SAFER than IV narcotics in my opinion. I always support the patients wishes whatever they may be... if someone wants meds I just educate them on pros and cons so they know what they are getting... but never try to talk them out of it. It;s their labor, their body.
    Holy cow, I am just so shocked at the epidural rate! Labor with out drugs is so possible! Especially if you have some tools and a good support person. ( I know I will get some comment on this!)
    Okay, so lots of people will say "why bother when there are so many good drugs available?" And who, exactly is most convenienced by the administration of these drugs????
    Well, I don't believe in antibiotics as cure-all for anything/everything/gee, I sniffled either....... Antibiotics are one of the top ten great accomplishments in medical history but I believe they are hugely over-prescribed.

    I thank you for assessing your pt's labor and wishes and making a connection between the two! I really don't have a place saying much until I get into the caregiving phase of my schooling. I knew that epidurals and/or narcotics pose minimal affects to the baby and that I needed neither to cope with my l/d.

    I had a GREAT l/d nurse when I had my second baby who listened when I told her my first labor had gone faaaasssst and she had all the "stuff" ready when I progressed from 5 to 10 cm's in 16 minutes ( my husband timed it....) and I was ready to go.

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