A total of 17 studies published from January 1st, , to September 2nd, , with a total of 1, participants involved were included in the present review. There was no record of conceptus vitality decrease associated with low doses of pethidine being administered to mothers during labor. Intramuscular IM or intravenous IV pethidine at low doses, of up to 50 mg, is safe to administer during labor. In order for a drug to be considered safe to be used during labor, it must be unable to cause deleterious changes that could result in any sequel to the mother or her conceptus.
Rev Dor. The pain and behavior of women during labor and the different positions for childbirth. Science has been trying to solve this problem for centuries; however, progress has been slow in achieving this goal.
Rio de Janeiro: Elsevier; , but, even after nearly years, medicine has not found any potent, safe, easy to use and affordable drug to be administered during this period.
The side effects of the drugs used during pregnancy have always been a medical concern. A drug that is safe for the mother can be harmful to the conceptus because of its immaturity. Therefore, the use of any drug should take into account maternal and fetal safety.
New York: McGraw-Hill; For the past 50 years, the gold standard in labor analgesia has been continuous epidural anesthesia. Continuous epidural analgesia for labour and delivery: review of cases. Can Med Assoc J ;95 19 When it is not available, contraindicated or refused, opioids are the best option.
A randomized controlled trial of intravenous remifentanil compared with intramuscular meperidine for pain relief in labor. J Med Sci ;7 04 Pethidine is an opioid derivative first synthesized in in Germany.
Pethidine in labour; results in cases. BMJ ; 1 Like any drug, it has its potency and its side effects related to the administered dose. During labor, pethidine may be administered intravenously IV, at doses between 25—50 mg or intramuscularly IM, at doses between 50— mg.
Lisboa: Permanyer Portugal; It has been used for 76 years in labor analgesia, with various dosages and routes of administration. Pethidine level in Jordanian women and their newborns during labor after a single intravenous dose.
Int J Clin Anesthesiol. Rev Med Minas Gerais. Labour analgesia and the baby: good news is no news. Intrapartum fetal distress. J Obstet Gynaecol India ;55 02 This drug has not been correlated with significant negative impacts on the maternal organism when administered in moderate doses during labor. Opioids, analgesia, and pain management. Goodman and Gilman's the pharmacological basis of therapeutics. After analyzing conflicting studies about the safety of pethidine for the conceptus, many services are decreasing or abolishing its use during labor.
This systematic review aims to compare the results of 17 studies involving pethidine use during labor. The purpose is to verify if pethidine is safe for the conceptus. The following keywords were used alone or combined with each other: pethidine in labor. A total of articles were found. The exclusion criteria were: a repeated articles; b systematic review articles; c lack of evaluation of conceptus vitality; d studies using pethidine associated with promethazine; e sample size below 25 patients; f articles whose participants were not given pethidine IV or IM; g non-randomized articles, h meta-analysis articles; and i articles of very restricted access.
Systematic reviews and meta-analyses were excluded to avoid duplication in the data analysis; articles with less than 25 patients were not included because they are more prone to erroneous conclusions; non-randomized studies were left out of the review because they have less reliable results, and studies in which promethazine was administered were excluded because promethazine can cause respiratory depression in the newborn.
Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk. Promethazine; p. After exclusion of 68 duplicated articles, were selected; of these, 11 were excluded because they were systematic reviews; 3 articles did not assess the conceptus vitality; 4 were excluded because they used promethazine; 3 studies were excluded because they had less than 25 participants; articles were excluded for not using pethidine IV or IM in labor analgesia; 6 articles were non-randomized, and 8 were excluded for being of very restricted access.
Finally, 17 articles were analyzed for the present review, being 10 free-access articles and 7 restricted-access articles Fig. The 17 remaining articles, which included a total of 1, participants to whom pethidine was administered during labor, were analyzed Table 1.
They were grouped in order according to the drug dosages administered from the lowest to the highest dosages to facilitate the analysis. There was a wide variation in the number of participants in each study, from 25 to Seven articles compared pethidine with placebo totaling participants , and 10 articles compared pethidine with another analgesic drug totaling participants. Even when compared with other drugs, it was possible to analyze the safety of pethidine for the conceptus when it was administered during labor.
Most studies involving pethidine in labor analgesia are conducted in the developed countries of North America or Europe. Emerging countries are more concerned in seeking options for labor analgesia. A total of 10 articles were published in the past 7 years. The 7 articles in which pethidine was administered at a dose of 50 mg were published in the past 7 years.
The articles show that currently there is a tendency to use lower doses of pethidine. Several articles provided incomplete data for an optimal analysis.
Some articles did not publish the Apgar scores; others articles did not report how many newborns required cardiopulmonary resuscitation, admission to the nursery or intensive care unit ICU. An ideal evaluation of newborn vitality should include at the same time: the Apgar score; the need for ventilator assistance; and an analysis of the umbilical vein blood, to determine the pH and the blood gases.
The analysis of some of these parameters alone or partially combined may not show the correct answer to the harm caused by the use of certain medications. Only one study used the neurological and adaptive capacity score NACS , which is inaccurate and unreliable. The neurologic and adaptive capacity score is not a reliable method of newborn evaluation. Pethidine is a strong painkiller. It is a similar drug to morphine and a type of opioid.
This is an injection given into your leg or bottom. It may help lessen your pain, especially if used alongside other methods. The injection can make you feel drowsy, dizzy or sick. It takes about 20 minutes to works and lasts 2 to 4 hours. An epidural is a local anaesthetic given in your lower back.
A drip will be put in a vein in your arm to give you some intravenous fluids beforehand. These keep your blood pressure stable. It takes about 10 minutes to set up the epidural tube, and another 10 to 15 minutes for it to work.
A tube called a catheter will be inserted into your bladder to drain urine once the epidural is in place. It stays in place for up to 8 hours after the birth. Pethidine is used to treat pain, particularly during childbirth. It is usually given by injection and provides pain relief for up to four hours. The most common side-effects are feeling dizzy or sleepy, sweating and feeling sick nausea. In this article About pethidine Before having pethidine How pethidine is given Getting the most from your treatment Can pethidine cause problems?
How to store pethidine Important information about all medicines. Pethidine for pain relief In this article About pethidine Before having pethidine How pethidine is given Getting the most from your treatment Can pethidine cause problems?
Common pethidine side-effects What can I do if I experience this? Feeling sick nausea or being sick vomiting Stick to simple foods. Drink plenty of water to replace any lost fluids Feeling dizzy, sleepy or drowsy If this happens, do not drive and do not use tools or machines.
Do not drink alcohol Other common side-effects include headache, dry mouth, constipation, feeling flushed, itchy skin rash, sweating, feeling confused, difficulties passing urine, shallow breathing If any of these occur, speak with your doctor. If you have any questions about this medicine ask your pharmacist. Are you protected against flu? Further reading and references. Join the discussion on the forums. Health Tools Feeling unwell?
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