Analgesics and Anesthetics Commonly Used in Labor and Birth (Karch, 2015)
Type Drug Usual Effect on Mother Effect on Labor Effect on Fetus or
Dosage/Route Progress Newborn Narcotic Meperidine 25 mg IV, 50–100 Effective analgesic; Relaxation, possibly Should be given 3 hr analgesic (Demerol) mg IM q3–4 hr; also feeling of well being aiding progress during before birth to avoid epidurally cervical relaxation. respiratory depression in Slows labor contractions newborn. Decreases if given early. beatto-beat variability in FHR. Nalbuphine 10–20 mg IM q3–6 Slowing of respiratory Mild maternal sedation Results in some (Nubain) hr, 0.3–3 mg/kg over rate; effective analgesic respiratory depression 10–15 min IV Butorphanol 1–2 mg IM or IV q3- Withdrawal symptoms if Possible slowing of labor Results in some (Stadol) 4 hr woman is opiate if given early respiratory depression dependent Morphine Intrathecally 0,2-1 Pruritus; effective Possible slowing of labor Some respiratory sulfate mg; 5 mg epidurally analgesia contractions depression Fentanyl 50–100 µg IM or 25- Hypotension; respiratory Slowing of labor if given May result in respiratory (Sublimaze) 50 µg IV; also depression early depression epidurally Lumbar Local anesthetic Administered for Rapid onset, in minutes; Slowing of labor if given May be some differences epidural bupivacaine first stage of labor: lasting 60-90 min; loss of early; pushing feeling in response in first few block (Marcaine), with continuous pain perception for labor obliterated, resulting in days of life ropivacaine block, anesthesia contractions and birth; possible prolonged (naropin) will last through possible maternal second stage birth; injected at L3- hypotension 4; fentanyl or morphine possibly added Pudendal Local anesthetic Administered just Rapid anesthesia of None apparent None apparent block lidocaine before birth for perineum (Xylocaine) perineal anesthesia; injected trough vagina Local Local anesthetic Injected just before Anesthesia of perineum None apparent None apparent infiltration of lidocaine episiotomy incision almost immediately perineum (Xylocaine) General Thiopental Administered IV by Rapid anesthesia; also Forceps required because Results in infant being intravenous anesthesiologist or rapid recovery abdominal pushing is no born with CNS anesthetic nurse anesthetist longer possible depression
Sumber: Karch, A. M. (2015). Lippincott’s Nursing Drug Guide. Philadelphia: Lippincott Williams & Wilkins.
Table. Gambaran pengalaman nyeri saat persalinan dan melahirkan
Kala Sensory Affective Kala I Keram, sakit, nyeri tajam, terasa Exciting, intens, kelelahan, ketakutan, berat, nyeri berdenyut, nyeri tertahankan atau tidak tertahankan, menusuk, seperti diiris, bersifat distress, menakutkan, menyiksa, tidak intermiten, terlokalisasi dan global. dapat digambarkan, luar biasa, menelan. Kala II Tekanan menyakitkan, terbakar, Kelelahan, luar biasa, perasaan tidak merobek, tajam, eksplosif, biasa, tidak fokus, mengerikan, kurang terlokalisasi. intens.
Comparison of Analgesic Effects of Intravenous Nalbuphine and Pentazocine in Patients Posted For Short-Duration Surgeries A Prospective Randomized Double-Blinded Study