Sterile Water Papule--have you ever heard of this?

Specialties Ob/Gyn

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Specializes in private duty/home health, med/surg.

I am currently in an L&D clinical rotation. Today, one of the patients was having bad back labor (yes, I know--is back labor ever good?). Her CNM relieved her pain with sterile water papules. I have never, ever seen or heard of this.

The CNM had a syringe filled with sterile water. She made 4 wheals (think TB test) on the patient's lower back, 2 on each side of the spine. It hurt the patient very bad for about 30 seconds, like a yellow jacket sting, but then all of a sudden no more back pain!!!! It was amazing! The CNM explained that this is based on the gate control theory; the hypotonic sterile water causes something to rush to that site & I forget the rest of the explanation. The patient said she wished she had received it hours earlier.

Has anyone else here heard of this treatment for back labor? According to the CNM, it can be used for all sorts of pains.

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

Yes, these are used often by midwives and some nurses for treatment of back labor. It'a extremely painful to get these papuled injected, but once done, women can have 2 or more hours of good relief from back labor. Not a new intervention, but in many hospitals, where epidural and intrathecal anesthesia is employed more and more, you see this technique used less and less. I am glad this low-tech and low-risk intervention worked so well for your patient. Midwives have an amazing way of helping women through labor w/o always having to resort to high-tech interventions to do so.

Here are a couple articles discussing the use and benefits and history of the of sterile water injections for pain:

http://anesthesiologyinfo.com/articles/cbe/blsubq.php

http://www.birthsource.com/proarticlefile/proarticle69.html

http://www.gentlebirth.org/archives/position.html#Sterile

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Specializes in MS Home Health.

Wow learn something new every day! As having had to natural childbirths with pit/mucho pain quick/I would have liked that.

renerian]

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Specializes in private duty/home health, med/surg.

Thanks for posting the links, SmilingBlueEyes. Can I ask what area of the country you live in? I'm curious because my clinical instructor said that although she's heard of this technique, today was the first day she'd ever seen it performed.

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

I live in the wonderful Pacific Northwest. (near Seattle).

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I saw lots of this used in CT where we had midwives. Here in FL no one uses it (but no midwives here either). When it worked it really worked well. But sometimes it didn't work at all. It seemed key to choose the proper placement of the wheals. The mom's reallly screamed when it was being done but if it worked they were so relieved that they didn't mind.

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Yup, but I've never seen it done (or offered for that matter) as of yet. Our nurse educator (also a CNM) said that she has used it and it works well.

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I worked L&D 10 years and never heard of that either. I guess it was the city I lived in too as we were a small community hospital. You never quit learning.

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Some of our CNM's do the sterile water thing on occasion. They burn like fire!

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Some of our CNM's do the sterile water thing on occasion. They burn like fire!

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