Name: Mariano, Jackson R.

Date:03/12/2021
Year/Section: BSN-2
Analgesics and Anesthetics Commonly Used in labor and Birth
Type Drug Usual Dosage/Route Effect on Mother Effect on Labor Effect on Nursing Consideration
Progress Fetus/Newborn
Narcotic Meperidine 25 mg IV Effective analgesic; Relaxation, possibly Should be given 3 A narcotic agonist such as
Analgesic (Demerol) 50-100 mg IM feeling of well- aiding progress during hour before birth to naloxone(Narcan) should be
q3-4 hr;also being cervical relaxation. avoid respiratory available for administration
epidurally Slows labor depression in whenever a narcotic is given during
contractions if given newborn. labor.
early Decreases beat-to- If severe infant respiratory
beat variability in FHR depression is anticipated, naloxone
Nalbuphine 10-20mg IM Slowing of Mild maternal Results in some can be given to a woman just
(Nubain) q3-6 hr, respiratory rate; sedation respiratory depression before birth
0.3-3 mg/kg over 10- effective analgesic
15 min IV

Buthorpanol 1-2 mg IM or IV withdrawal Possible slowing of Results in some

(Stadol) q3-4 hr symptoms if labor if given early respiratory depression
woman is opiate
dependent
Morphine Intrathecally Pruritus; effective Possible slowing of Some respiratory
sulfate 0.2-1 mg analgesia labor contractions depression
5mg epidurally
Fentanyl 50-100 µg IM or Hypotension;respir Slowing of labor if May result in
(Sublimaze) 25 µg IV; also atory depression given early respiratory depression
epidurally
Lumbar Local anesthetic Administered for Rapid onset,in Slowing of labor if May be some The patient must not lie down
epidural block Bupivacaine first stage of labor; minutes; given early; differences in before administration and must lie
(Marcaine), with continuous lasting 60-90 min; pushing feeling response in first few down after administration for the
ropivacaine block, anesthesia will loss of pain obliterated, resulting days of life drug to be effective.
(Naropin) last through birth; perception for in possible prolonged IV fluids such as lactated Ringers
injected at L3-4; labor contractions second stage solution are usually given before
fentanyl or morphine and birth; injection to ensure hydration and
possibly added possible maternal guard against hypotension.
hypotension If headache occurs, ask the
woman to life flat and administer
an analgesic. Some women find a
cold cloth applied to forehead
 helpful.
If a headache is incapacitating, it
can be treated with a blood patch
technique.
Pudendal Local anesthetic Administered just Rapid anesthesia None Apparent None Apparent Assess fetal heart rate and the
block Lidocaine before birth for on perineum mothers blood pressure
(Xylocaine) perineal anesthesia; immediately after the injection to
injected through be certain maternal hypotension
vagina does not occur.
Local Local anesthetic injected before Anesthesia of None apparent None apparent This anesthetic is used when the
infiltration of Lidocaine episiostomy incision perinium almost fetal head is too low for a pudendal
perineum (Xylocaine) immediately block.
General Thiopental Administered IV by Rapid anesthesia; Forceps required Results in infant being Infants born using this anesthetic
intravenous (Pentothal) anesthesiologist or also rapid recovery because abdominal born with CNS may need resuscitation.
ansthetic nurse-anesthetist pushing is no longer depression Observe women for signs of urine
possible atony and postpartal hemorrhage.
An adult laryngoscope, an
endotracheal tube, a breathing bag
with a source of 100% oxygen and
a suction source should be at hand.
To ensure safe general anesthesia
administration, a minimum of 6
drugs should be readily available
 Ephedrine to use in the
event blood pressure falls
 Atropine sulfate to dry oral
and respiratory secretions
to prevent aspiration
 Succinylcholine(Anectine)
to achieve laryngeal
relaxation for intubation
 Diazepam(Valium) to
control seizures, a possible
reaction to anesthetics
 Isoproterenol(Isuprel) to
reduce bronchospasm,
should aspiration occur.