Half as many women in labour who were given a drug called remifentanil to help manage their pain needed a subsequent epidural, compared to the women given pethidine - the current standard of care, according to an open-label randomised controlled trial of 400 women from 14 maternity units in the UK published in The Lancet. Epidurals - injections of pain relief drugs around the spinal cord - provide effective pain relief but increase the risk of needing instrumental delivery (forceps or vacuum) during birth, which in turn can increase the risk of trauma and long-lasting problems for the mother, such as incontinence and sexual dysfunction.
Pethidine is given to more than a quarter of a million women in labour each year in the UK, and many more worldwide. In the UK and Europe, remifentanil is rarely offered routinely in labour and its use restricted to women who cannot receive an epidural…
