Managing Complications in Pregnancy and Childbirth: - IAWG

ANAESTHESIA AND ANALGESIA C-37Pain relief is often required during labour and is required during andafter operative procedures. Methods of pain relief discussed belowinclude analgesic drugs and methods of support during labour, localanaesthesia, general principles for using anaesthesia and analgesia andpostoperative analgesia.ANALGESIC DRUGS DURING LABOUR• The perception of pain varies greatly with the woman’s emotionalstate. Supportive care during labour provides reassurance anddecreases the perception of pain (page C-57).• If the woman is distressed by pain, allow her to walk around orassume any comfortable position. Encourage her companion tomassage her back or sponge her face between contractions.Encourage the use of breathing techniques and allow the woman totake a warm bath or shower if she chooses. For most women, this isenough to cope with the pain of labour. If necessary, give:- pethidine 1 mg/kg body weight (but not more than 100 mg) IMor IV slowly every 4 hours as needed or give morphine 0.1mg/kg body weight IM;- promethazine 25 mg IM or IV if vomiting occurs.Barbiturates and sedatives should not be used to relieve anxietyin labour.DANGERIf pethidine or morphine is given to the mother, the baby may sufferfrom respiratory depression. Naloxone is the antidote.Note: Do not administer naloxone to newborns whose mothers aresuspected of having recently abused narcotic drugs.• If there are signs of respiratory depression in the newborn, beginresuscitation immediately:- After vital signs have been established, give naloxone 0.1mg/kg bodyweight IV to the newborn;