Epidural alternative recommended for women in labour

New draft guidelines for the NHS say women in labour should be offered an alternative to an epidural spinal block injection.

The National Institute for Health and Care Excellence is recommending remifentanil, a fast-acting morphine-like drug given through a vein.  Women control the medication themselves, by pressing a button to release more of the drug for pain relief.  A timer ensures too much of the medication cannot be given.

NICE say having the drug as a treatment option has advantages – it might enable women to be more mobile than with an epidural, which makes the legs numb and weak, for example.

Evidence also suggests fewer epidurals may mean fewer births using instruments like ventouse vacuum suction and forceps, according to NICE.

Remifentanil is a strong painkiller that provides quick pain relief, acting within 20-30 seconds and wearing off in minutes.  It does cross the placenta, meaning the baby will have a small exposure to the drug, but it wears off quickly and its use in large numbers of women suggests it is safe, according to experts.

The drug is not currently used by every maternity unit, so the National Childbirth Trust advises women to discuss with their midwife whether it is available where they plan to give birth.

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Posted by Karen Motley, Clinical Negligence Department, Chadwick Lawrence LLP (jacquelinevance@chadlaw.co.uk), medical negligence lawyers and clinical negligence solicitors in Huddersfield, Leeds, Wakefield and Halifax, West Yorkshire.

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