Epidural Lofentanil for Pain Relief in Labor

Abstract

The medullary use of opiates appears to be an attractive alternative in obstetrical analgesia. Narcotics injected into the peridural space have no effect on the sympathetic and motor neurons and little effect on non-nociceptive sensory transmission, i.e., light touch and proprioception. Since these characteristics exclude both hypotension due to extensive sympathetic blockade by local anesthetic agents and paresis of the abdominal wall muscles, the number of instrumental deliveries is thus reduced. The parturient herself can provide useful information as to the intensity of uterine contractions or pain. During the second stage, the mother feels the descent of the presenting part on the pelvic floor and the distension of the pelvic gutter and calls for relief. In this way, built- in safety guidelines help control the use of epidural opiates.