IV Fentanyl for labor...

RaeT,RN · Feb 16, 2006

We use Fentanyl in our epidurals and spinals. We very seldom use it IV.

The only thing about it in the spinals and epidurals that I can attest to is that it makes the pt's itch. Not sure if this also rings true for IV use or not.

rpbear · Feb 16, 2006

Some of our doc's and CNM will order IV fentanyl, usually 50 - 100 mcg to repeat every 1-2 hours. It seems to work well on most pt's. It does cause resp problems in the baby if given within the hour before birth. This only seems to happen in multips who quickly go from 8cm to delivered since the med is so short acting, only lasts about 1 hour. I have not seen the itchig with the IV dose vs the epidural dose (we use it in our epidurals too).

tdr61 · Feb 16, 2006

Some facilities I've worked at use fentanyl during labor, just as rpbear stated...50-100mcg IVP. I haven't seen the itching with the IV dose and it seems to work better than stadol for most patients.

Ten

SmilingBluEyes · Feb 16, 2006

We do not use IV fentanyl for laboring women, where I work now. Where I used to, we did but with one stipulation. They had to be on pulse oximetry when it was in use. The usual doses varied by practitioner, but it was something like 50-100 mcg every 2-4 hours.

We use IV Stadol or Nubain for labor pain relief where I am now.

The Nubain is used 5-20 mg q 1-2 hours (based on dose)

The Stadol dose is 1-2 mg every 2 hours.

lafrn97 · Mar 1, 2006

The IV med of choice at my facility is fentanyl. Only 1 doc uses stadol. 50 q 5 min prn- up to 150/hr. Usually 2 doses in a 5 min interval does the trick for heavy labor. Same effects as stadol as far as variability goes. We don't give it to multips who are 8 cm or farther.

IBCLCMindy · Mar 2, 2006

I've used it for laboring patients as a CNM. I don't really like it very much as it seems to make mom's confused and unable to work with UC's during the time that it is most active. But I really dislike it for the effect on the baby--seems to interfere with their sucking coordination and many have a hard time latching effectively. My year's worth of practice had a high percentage of babies with breastfeeding problems following fentanyl use, compared to our unmedicated babies.

lafrn97 · Mar 2, 2006

I've used it for laboring patients as a CNM. I don't really like it very much as it seems to make mom's confused and unable to work with UC's during the time that it is most active. But I really dislike it for the effect on the baby--seems to interfere with their sucking coordination and many have a hard time latching effectively. My year's worth of practice had a high percentage of babies with breastfeeding problems following fentanyl use, compared to our unmedicated babies.

Good to know. I work in L&D and don't get too far into recovery to notice the difference of fent. babies vs non medicated babies. Is there the same effect with other meds. ie:stadol?