Taking the alternative route: Women's experience of intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for labour analgesia

Abstract

For women requesting parenteral analgesia, fentanyl administered by less invasive routes offers women additional options that may better meet their emotional, cognitive and physical needs than the current practice of administering intramuscular pethidine.

Qualitative exploration of women’s experiences of intramuscular pethidine or remifentanil patient-controlled analgesia for labour pain

“…This was consistent with the findings of the RESPITE trial, which showed that women’s views of their pain relief effectiveness and average pain scores were significantly better in the remifentanil arm 10. These insights also support a recent study by Fleet and colleagues,9 who compared women’s use of pethidine and fentanyl (delivered on an intranasal or subcutaneous basis). Fleet and colleagues’ study found that women who received fentanyl provided more positive, and less negative responses compared to those who received pethidine 9.…”

“…These insights also support a recent study by Fleet and colleagues,9 who compared women’s use of pethidine and fentanyl (delivered on an intranasal or subcutaneous basis). Fleet and colleagues’ study found that women who received fentanyl provided more positive, and less negative responses compared to those who received pethidine 9. However, it is important to note that while effective pain management has become an essential component of the care plan for expectant mothers, women’s perceptions of pain are affected by physiological and/or psychological issues (eg, fear, anxiety),15 as well as the nature of the woman-provider relationship 16…”

“…Known side effects of remifentanil include respiratory depression, nausea, pruritus, and decreased heart rate and blood pressure, although there are currently too few studies of remifentanil PCA use in labour to draw definite conclusion with respect to side effects for women and newborns 8. Route of analgesia administration has been found to positively impact on women’s experiences of labour, with women who self-administered analgesia (intranasal fentanyl) reporting increased autonomy and satisfaction compared to women who relied on the midwife to administer analgesia, who were more often focused on the physical effect of the drug 9. The influence of remifentanil on infant feeding behaviours remains largely unexplored.…”

Spectroscopic Behavior, FMO, NBO Analysis of Pethidine and Diclofenac Drugs by Theoretical Approach

“…The analysis of the various donors and acceptors indicate that there are only three types of donors σ, π & LP, and two types of acceptors σ * and π * [33]. The observation of excitation energy (2) for different transitions among these donors and acceptors shows that the chances for the pethidine drug following transitions are highly probable; from C1─C2 → C3─C4 (43.180 kj/mol, π → π * ), C13─C14 → N15─C18 (5.070 kj/mol, σ→ π * ), O9 → C8-O10 (63.110 kj/mol, LP (2) → π * ) and O10 → C8-O9 (37.510 kj/mol, LP (2) → σ * ). For diclofenac drug following transitions are highly probable; from C3─C4 → C1─C2 (48.650 kj/mol, π → π * ), C8─C9 → C10─C11 (49.370 kj/mol, π → π * ), O18 → C17─O19 (50.74 kj/mol, LP (2) → π * ) and O18 → C17─O18 (42.99 kj/mol, LP (2) → π * ) ( Table 6).…”

“…Meperidine is often a preferred analgesic drug used to relieve migraine headaches. Meperidine is indicated for the treatment of moderate to severe pain, and is delivered as syrup, intramuscular, and intravenous injection [1,2]. Meperidine is a phenylpiperidine derivative, which is firstly synthetic analgesic drug to achieve the wide therapeutic usage [3,4].…”