Pain Relief Medications and Anesthetics

It is important to understand options available for the treatment of pain and nausea during labor. There are a number of medications that may be administered to you, which can help you through some of the more difficult stages of labor. However, these medications may also have side effects, not only for you, but also for your baby. You should discuss these medications and other pain relief alternatives in-depth with your doctor before you make a decision about medication you would like to receive during labor or delivery.

Common Medications

Demerol or morphine – narcotic pain relief. May cause nausea, sleepiness or decrease alertness. Decreases your body’s stress response to pain, which may benefit both you and your baby.
Stadol – pain reliever similar to, but not as potent as, narcotics. Similar actions to the drugs above, but frequently causes sleepiness, and rarely, an uncomfortable anxious feeling.
Phenergan – prevents or treats nausea. Provides sedation but may cause dizziness.
Vistaril – antinauseant with similar actions to Phenergan. Also decreases tension or anxiety. May cause sleepiness.

There are other methods of pain relief you may wish to consider to help you deal with pain not only during your labor, but also your delivery, whether delivery occurs spontaneously through your vagina or is a result of a Cesarean section. Options may range from natural childbirth to general anesthesia. Some methods can be used in combination such as a local block in combination with natural childbirth. General anesthesia is usually reserved for emergent situations. Although it is generally safe, potential side effects or complications from a general anesthetic are greater for you and your baby.

Blocks and anesthetics

Local block – involves numbing the perineum with a local anesthetic solution for the episiotomy and suturing. This is given just before delivery.
Pudendal Block – involves injecting a local anesthetic around nerves just inside the vagina, thus numbing the vaginal canal and perineum. This is performed just before delivery.
Modified Saddle Block – involves placing a small needle in the spinal sack of your lower back and injecting a small amount of local anesthetic solution. This produces numbness from your navel to your toes and provides excellent pain relief for delivery and a decrease in the stress reaction from pain. Potential side effects include decreases in your blood pressure and the possibility of a post-spinal headache.
Spinal Block – similar to the modified saddle block, however, the numbness usually extends from your mid-chest to your toes. This method is usually used for cesarean. Also, a small amount of morphine or another narcotic may be placed in the anesthetic solution before injection. This can provide 12-18 hours of pain relief after a cesarean. Potential side effects are similar to the saddle block. If a narcotic is injected, additional side effects may include nausea, itchiness or sedation. You will be monitored for these and easily treated if the need arises.
Continuous Lumbar Epidural Anesthesia – involves the placement of a needle just outside the spinal sack in your lower back, after numbing your back with a local anesthetic, and then threading a small flexible catheter through the needle. After the needle is removed, this catheter lies immediately outside the spinal sack in the epidural space. The other end of this catheter, remaining outside your back, is then used to inject various pain medications and local anesthetics into this epidural space, thus decreasing your pain of labor and delivery. Also, morphine can be injected into the epidural after a cesarean to provide long-term pain relief. The side effects of this technique are similar to the spinal block.
General Anesthesia – involves the injection or inhalation of medication which causes you to loose consciousness, thus relieving pain. This technique is used in emergencies or in other special situations.

Local anesthetic blocks, such as numbing the perineum or a pudendal block are administered by your doctor. Other options, such as saddle blocks, spinal blocks, continuous lumbar epidural anesthesia (with or without morphine) and general anesthesia are administered by an anesthesiologist.

Note – the reasons for and potential side effects of the techniques described above are not intended to be all inclusive. Please talk to your doctor or your anesthesiologist for a more complete description of the indications for, and potential side effects of, these options.

Watching Baby Grow
Complications of Pregnancy
Labor & Delivery
Pain Relief Medications & Anesthetics
Cesarean Birth & VBAC