Subcutaneous fentanyl for labour analgesia: a retrospective case note review.

International Journal of Obstetric Anesthesia
J-A FleetA M Cyna

Abstract

In 2017, a South Australia Perinatal Practice Guideline was introduced state-wide for the use of subcutaneous fentanyl for labour analgesia as a replacement for intramuscular pethidine. We retrospectively reviewed the implementation of this practice change in our institution. A retrospective review of maternal and neonatal case notes for the first 100 women administered subcutaneous fentanyl in labour at a single tertiary referral centre for maternity care, between February and June 2017. Of the 102 women administered subcutaneous fentanyl, the majority (55%) were primipara, with an average maternal age of 29 years and body mass index of 27 kg/m2. The median total fentanyl dose administered was 200 µg and the average time from last dose to birth was 3 h. The majority of women (70%) did not require additional rescue labour analgesia and 80% had a spontaneous vaginal birth. All neonates had a 5-min Apgar score >7. The median Apgar score at 1 and 5 min was 9. No neonate had an arterial cord blood pH <7.1. The mean arterial and venous cord blood pH was 7.3. The average time for neonates to establish breathing was 1 min and the median postnatal length of stay was two days. Subcutaneous fentanyl for labour analgesia appears effective...Continue Reading

References

Nov 18, 2009·European Journal of Anaesthesiology·Sarah J CapperGuy L Ludbrook
May 4, 2011·Journal of Midwifery & Women's Health·Deborah Anderson
Jan 27, 2012·Women and Birth : Journal of the Australian College of Midwives·Kelly L MaddenChris Wilkinson
Jan 7, 2015·BJOG : an International Journal of Obstetrics and Gynaecology·J FleetA M Cyna
Jan 15, 2016·European Journal of Clinical Pharmacology·Astrid W OostenRon H J Mathijssen
Apr 9, 2016·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Johann LebonAlain Tanguay

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