Pain Relief
Entonox...............................................................2
• What is Entonox
• How to use Entonox
• Mother - side effects
Pethidine.............................................................3
• What is pethidine
• Pethidine administration
• Mother – side effects
• Baby – side effects
Epidural Analgesia..............................................5
• What is epidural analgesia/Anatomy
• Insertion
• Post insertion
• Side effects
• Complications
TENS…………………………………………….16
• What is TENS
• How to use
• Advantages and disadvantages
Non-Pharmacological forms of pain relief……18
Useful videos……………………………..20
LH
1
, What is Entonox?
Entonox, or ‘gas and air’ is an inhalation analgesia consisting of 50%
nitrous oxide and 50% oxygen. Entonox can be taken by breathing
through a mouthpiece or mask. Entonox is best used as contractions
begin and holds no evidence of any effect on your baby.
~How to use~
*Hold mouthpiece between the teeth
*Extract the gas by breathing in
through your mouth
*TIP* Deep breathing is seen to be
most effective
~Mother - side effects~
Entonox can make one feel a little bit dizzy, drowsy or confused.
Other side effects include dry mouth, poor memory and nausea and
vomiting
*TIP* Use a cool facecloth on the back of the neck or forehead to help
with nausea
Benefits Risks
No long lasting side effects Unsuitable for vitamin B12
deficiencies
Puts you in control Unsuitable to use with respiratory
diseases
Does not affect your baby Poor recollection of labour
LH
2
, What is Pethidine?
Pethidine is a synthetic opioid similar to morphine that offers limited
pain relief. It is injected intramuscularly into the buttock or thigh and
provides 1-2 hours of pain relief. Timing is key when administering
pethidine as it has seen to increase the risk of neonatal depression when
given 2-4 hours before birth. It is important to monitor the mother’s
respiration rate as the mother can develop hypoxia with pethidine.
Pethidine Administration
Temperature stored: 2-8 °C
Dose: 50-150mgs
Depending on: Site of administration
Woman's weight
Stage of labour/progress of labour
Degree of pain
Primagravida (higher dose)
Multigravida (lower dose)
Mother – side effects
• Urinary retention – due to its anti-spasmatic effects
• Loss of self control - Can make the woman violent/unpredicatble
• Hypotension – due to its depletion of blood volume
• Rate and depth of breathing decreases
• Prolonged 1st and 2nd stage of labour
• Poor memory of labour
• Effects prolactin levels – resulting in problems with initiation of
breastfeeding
• Plasma levels remain high up to 13-23 hours
LH
3
Entonox...............................................................2
• What is Entonox
• How to use Entonox
• Mother - side effects
Pethidine.............................................................3
• What is pethidine
• Pethidine administration
• Mother – side effects
• Baby – side effects
Epidural Analgesia..............................................5
• What is epidural analgesia/Anatomy
• Insertion
• Post insertion
• Side effects
• Complications
TENS…………………………………………….16
• What is TENS
• How to use
• Advantages and disadvantages
Non-Pharmacological forms of pain relief……18
Useful videos……………………………..20
LH
1
, What is Entonox?
Entonox, or ‘gas and air’ is an inhalation analgesia consisting of 50%
nitrous oxide and 50% oxygen. Entonox can be taken by breathing
through a mouthpiece or mask. Entonox is best used as contractions
begin and holds no evidence of any effect on your baby.
~How to use~
*Hold mouthpiece between the teeth
*Extract the gas by breathing in
through your mouth
*TIP* Deep breathing is seen to be
most effective
~Mother - side effects~
Entonox can make one feel a little bit dizzy, drowsy or confused.
Other side effects include dry mouth, poor memory and nausea and
vomiting
*TIP* Use a cool facecloth on the back of the neck or forehead to help
with nausea
Benefits Risks
No long lasting side effects Unsuitable for vitamin B12
deficiencies
Puts you in control Unsuitable to use with respiratory
diseases
Does not affect your baby Poor recollection of labour
LH
2
, What is Pethidine?
Pethidine is a synthetic opioid similar to morphine that offers limited
pain relief. It is injected intramuscularly into the buttock or thigh and
provides 1-2 hours of pain relief. Timing is key when administering
pethidine as it has seen to increase the risk of neonatal depression when
given 2-4 hours before birth. It is important to monitor the mother’s
respiration rate as the mother can develop hypoxia with pethidine.
Pethidine Administration
Temperature stored: 2-8 °C
Dose: 50-150mgs
Depending on: Site of administration
Woman's weight
Stage of labour/progress of labour
Degree of pain
Primagravida (higher dose)
Multigravida (lower dose)
Mother – side effects
• Urinary retention – due to its anti-spasmatic effects
• Loss of self control - Can make the woman violent/unpredicatble
• Hypotension – due to its depletion of blood volume
• Rate and depth of breathing decreases
• Prolonged 1st and 2nd stage of labour
• Poor memory of labour
• Effects prolactin levels – resulting in problems with initiation of
breastfeeding
• Plasma levels remain high up to 13-23 hours
LH
3
