Use of intrathecal analgesia in a rural hospital Case studies |
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| Affiliation: | 1. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada;2. Li Ka Shing Knowledge Institute, St. Michael''s Hospital, Toronto, ON, Canada;3. Department of Health & Society (Scarborough Campus), University of Toronto, Toronto, ON, Canada;4. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada;5. Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada;6. The Hospital for Sick Children, Toronto, ON, Canada;7. Department of Pediatrics, University of Toronto, Toronto, ON, Canada |
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| Abstract: | A woman's experience of unrelenting back pain with a fetus in an occipitoposterior position and the escalating interventions culminating in a cesarean birth is every midwife's nightmare. Intrathecal analgesia is a relatively simple and rapid method to provide maternal relaxation and relief from severe back labor. This article describes the use of intrathecal opioid analgesia in labor complicated by failure to progress in first-stage labor due to persistent occipitoposterior position of the fetus. Intrathecal analgesia has the advantage of being inexpensive and providing rapid onset of adequate pain relief for the first stage of labor. It does not cause motor blockade, so it allows the mother to be mobile and feel the urge to push. Consequently, there is no associated risk of an increased need for forceps or vacuum-assisted delivery. The authors note a decreased incidence of operative delivery for fetal occipitoposterior position with the use of intrathecal narcotics. |
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