What type of pain med in labor used?

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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?

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?

We use Stadol and Phenergan. Only anesthesia uses Fentanyl. Works great.

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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

Demerol is supposed to be VERY old-fashioned.We NEVER use it. Isn't it funny how trends are so different? We always use Phenergan. It can be irritating to the vein, but I have never seen anyone have a problem after delivery-long term. We take our IV's out during recovery (after a NVD) and the next morning (say about 12-18 hours) after a section.

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

Rofl ----I wanted to find that thread, but was too lazy. (imagine that rofl). :rotfl:

Anyhow, The IV Nurses' Association leads the way here, in strongly recommending not to use Phenergan IV. Good reasons exist why. It is a severe vessicant, with a reasonable risk of causing some permanent damage----- having an extremely low pH. And diluting it does not satisfactorily mitigate the vessicant properties to make this practice safe.

Personally, I have seen ONE case where Phenergan did do permanent damage and a lawsuit indeed followed. (yes only one case out of so many). But, One was more than enough for me. (thankfully it was not a suit in which I was personally the target). :)

Remember, in nursing, just cause a practice is widely accepted, does not mean it is the BEST practice, based on evidence. I know, I tend to keep forgetting that.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Demerol is supposed to be VERY old-fashioned.We NEVER use it. Isn't it funny how trends are so different? We always use Phenergan. It can be irritating to the vein, but I have never seen anyone have a problem after delivery-long term. We take our IV's out during recovery (after a NVD) and the next morning (say about 12-18 hours) after a section.

Rofl here we go again, me being the unpopular jerk. Demerol is NOT recommended as labor pain control medication.......it lowers seizure threshold in many healthy people. It metabolizes into noremeperidine (which is responsible for cerebral irritation and potentially causing seizure). I am surprised anyone is using Demerol at all in L and D. I know some places still use it in PP, but more and more are moving away from Demerol use, even there. For good reason. There are too many alternatives that are considered safer.

Ok back under my rock I go. :sofahider

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

Ah yes, nitrous; we only use it widely in the USA in dental offices for anxiety control, not pain control. I personally have used it due to severe dental phobia on my part, when I got a root canal. It would not have done a thing to mitigate pain, as far as I could tell, but did put me in "la la land" where I was able to relax enough to sit for the procedure and not freak out. It made me higher than a kite, really, but I knew everything going on around me. I have read they use this in labor in the UK many times. Does it work well?

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Epidurals :)

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

steph

At our hospital most moms have epidurals (about 90%). If no epidural our drug of choice is Dilaudid. We give 1 mg IV and 2 mg IM. We don't use Demoral or Stadol at all in labor. Occaisonally Nubain. It is interesting to see whay everyone else is using!

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We don't use Demerol in labor anymore . . . .as far as I know anyway. I'm not the only OB nurse. :)

Deb - I've discussed the vessicant issue about Phenergan with our pharmacist and docs .. we still use it. Especially in the ER. I gave morphine and phenergan IM the other day though . . .and thought of you. :)

steph

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We use Nubain and 80% of our patients get epidurals

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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Hi.

I don't post much but I read often. I had to jump in on this thread, though, b/c my hospital delivers close to 7,000 babies a year, yet I don't think anyone else's unit uses what we routinely administer.

Aside from around a 98% epidural rate, the most common pain meds ordered are Demerol 50mg mixed with 25mg Phenergan via IV push. Next is Stadol 1 or 2 mg IV push.

Can't say the the Demerol/Phenergan combo works well. Maybe for about an hour or so if it is really early labor.

Fentanyl is only used by the anesthesiologists.

I never knew that there were such problems with Phenergan. We use it so often!

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Specializes in Perinatal, Education.
Hi.

I don't post much but I read often. I had to jump in on this thread, though, b/c my hospital delivers close to 7,000 babies a year, yet I don't think anyone else's unit uses what we routinely administer.

Aside from around a 98% epidural rate, the most common pain meds ordered are Demerol 50mg mixed with 25mg Phenergan via IV push. Next is Stadol 1 or 2 mg IV push.

Can't say the the Demerol/Phenergan combo works well. Maybe for about an hour or so if it is really early labor.

Fentanyl is only used by the anesthesiologists.

I never knew that there were such problems with Phenergan. We use it so often!

We have about a 90% epidural rate. Other than that, it's either 1-2mg Stadol (which I hate because it doesn't work well and the babies often crumple later) and Nubain 5-10mg depending on the doc. We don't even have phenergan on the unit. One of our doctor has a standing order that states that no phernergan is to be given to his patients EVER (the orders have the capitalization). Maybe an old lawsuit? I don't know.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
We don't use Demerol in labor anymore . . . .as far as I know anyway. I'm not the only OB nurse. :)

Deb - I've discussed the vessicant issue about Phenergan with our pharmacist and docs .. we still use it. Especially in the ER. I gave morphine and phenergan IM the other day though . . .and thought of you. :)

steph

:rotfl:

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Ah yes, nitrous; we only use it widely in the USA in dental offices for anxiety control, not pain control. I personally have used it due to severe dental phobia on my part, when I got a root canal. It would not have done a thing to mitigate pain, as far as I could tell, but did put me in "la la land" where I was able to relax enough to sit for the procedure and not freak out. It made me higher than a kite, really, but I knew everything going on around me. I have read they use this in labor in the UK many times. Does it work well?

We used it in Canada all the time too. Some women loved it, for others it didn't work as well. The nice thing is it's so easy to try and we can just try something else if it doesn't work. I really liked having that option for my patients.

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