What type of pain med in labor used?

Specialties Ob/Gyn

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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?

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Epidurals :)

We have used Fentanyl. I've never used Stadol.

steph

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Mostly epidural like Steph.

We also use Stadol, Fentanyl, and Nubain for IV pain relief.

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Nubain/Phenergan IVP if pt. has an IV, otherwise IM. One doctor likes to give pt's IM Denerol/Phenergan even w/ IV and after they've had blood drawn, so they can be stuck one more time just for waking his highness up at night! He does not "believe" in epidurals, but our other docs will give them if pt. wants, esp. if they have tried sedation and it isn't helping any more or never did. No walking epidurals though. I wish we had them.

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Mostly epidurals, but also stadol or nubain IM or IV (one CNM orders tiny little doses of nubain subQ sometimes; works surprisingly well on some people).

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Specializes in Nurse Manager, Labor and Delivery.

We use nubain/phenergan IV...and epidurals. We have one doc who doesn't particularly like epidurals and believes in the power that a woman has inside to control pain. Although he denies it..he uses hypnosis with pretty good results. I would like to get good at that...at least for the families...lol

Nubain SQ?? Never heard of that one..but interesting

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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.

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Mostly epidurals, but also stadol or nubain IM or IV (one CNM orders tiny little doses of nubain subQ sometimes; works surprisingly well on some people).

Same as above where I work. Well, except the SQ Nubain.

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Specializes in Behavioral Health.

Nubain 5-10mg/Phenergan 12.5-25mg IV or epidural. I'm personally not a big fan of Phenergan....it's such a vesicant and I've seen a pt have the most god-awful reaction to it.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

that is why so many places, it is AGAINST POLICY to use phenergan except for IM use only. Good reasons exist why. It can and may cause phebitis and permanent injury if used IV. We are not allowed to give phenergan IV in any form, even diluted in 1L of fluid, anymore. I am glad now.

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that is why so many places, it is AGAINST POLICY to use phenergan except for IM use only. Good reasons exist why. It can and may cause phebitis and permanent injury if used IV. We are not allowed to give phenergan IV in any form, even diluted in 1L of fluid, anymore. I am glad now.

Oh my gosh we need to resurrect the "phenergan" thread to see how widely different the practice of giving it is.

We given phenergan all the time IV - I gave it the other day in the ER. I dilute it in 9 ml of NS. I've never had an IV go bad or had a case of phlebitis.

So funny how we all do things so differently in some cases. :)

I've have not, however, ever given phenergan for a laboring mom. When I first started 6 years ago, we did Demerol IM alot. I had Demerol when I was in labor - pointless - labor still hurts.

steph

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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.

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