GuidelinesOther guideline
Analgesia in Labour
The guidelines recommend management of common obstetric conditions at primary and referral level, based on local experience and evidence-based practice. They are not intended as strict protocols nor as standard operating procedures, but rather as a guide to safe effective management of common obstetric problems. The guidelines should be most useful to interns, medical officers and registrars.
Analgesia should not be withheld from women in labour
- Support & companionship have been shown to reduce the need for analgesic medication in labour
- Pethidine 1 mg/kg, (maximum dose 100 mg)
- OR
- Morphine 0.1 mg/kg (maximum dose 10 mg) IM 4 hourly is acceptable in both latent & active phases of labour.
- Pethidine 1 mg/kg, (maximum dose 100 mg)
- There is no need to run a CTG tracing before giving opioids.
- Metoclopramide 10 mg IM 4 hourly is given for nausea.
- Inhaled 50%/50% oxygen/nitrous oxide mixture by mask is useful in the late first stage (cervix dilated ≥8 cm). It may cause nausea & light-headedness.
- Epidural analgesia is useful in women with excessive pain, prolonged labour, hypertension, preterm labour & twin gestation; the anaesthetic department is responsible for administration & monitoring of epidural anaesthesia