Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/92553
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Type: Journal article
Title: A comparison of fentanyl with pethidine for pain relief during childbirth: a randomised controlled trial
Author: Fleet, J.
Belan, I.
Jones, M.
Ullah, S.
Cyna, A.
Citation: BJOG, 2015; 122(7):983-992
Publisher: Blackwell Publishing
Issue Date: 2015
ISSN: 1470-0328
1471-0528
Statement of
Responsibility: 
J Fleet, I Belan, MJ Jones, S Ullah, and AM Cyna
Abstract: OBJECTIVE: To compare the efficacy of fentanyl administered via the subcutaneous (s.c.) or intranasal (i.n.) route with intramuscular (i.m.) pethidine in labouring women requesting analgesia. DESIGN: A randomised controlled trial three-armed, parallel-design. SETTING: A regional hospital and the largest tertiary maternity centre in South Australia. SAMPLE: One hundred and fifty-six healthy parturients birthing at term. METHODS: Women were randomised to receive s.c. fentanyl (n = 53), i.n. fentanyl (n = 52), or i.m. pethidine (n = 51). The outcomes were analysed by intention-to-treat. MAIN OUTCOME MEASURES: Pain scores measured before and 30 minutes after opioid administration. RESULTS: All groups reported clinically significant reductions in pain scores (mean range 1.2-1.6; P < 0.001), with no significant differences between groups. Significantly more women in the fentanyl groups reported satisfaction with using the study drug again, compared with women receiving i.m. pethidine (82.9% i.n. fentanyl, 80.6% s.c. fentanyl, and 44.0% i.m. pethidine; P < 0.01). Women in the fentanyl groups experienced less sedation (i.n. fentanyl 7.3%, s.c. fentanyl 2.9%, i.m. pethidine 44%; P ≤ 0.03), shorter labours by at least 2 hours (P < 0.05), and fewer difficulties establishing breastfeeding (78.8% i.m. pethidine, 39.4% i.n. fentanyl, and 44.0% s.c. fentanyl; P < 0.01). Neonates in the pethidine group were more likely to require nursery admission (P < 0.02). CONCLUSIONS: Fentanyl administered by s.c. and i.n. routes is as efficacious in relieving labour pain as i.m. pethidine, but resulted in greater satisfaction, less sedation, shorter labour, fewer nursery admissions, and fewer difficulties in establishing breastfeeding. Fentanyl appears to be a suitable alternative to pethidine when providing parenteral pain relief to labouring women.
Keywords: Fentanyl; intramuscular; intranasal; labour; pethidine; subcutaneous
Rights: © 2015 Royal College of Obstetricians and Gynaecologists
RMID: 0030023125
DOI: 10.1111/1471-0528.13249
Appears in Collections:Nursing publications

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