Alternative to epidural recommended for women in labour
Women in labour should be offered an alternative to an epidural spinal block injection, say new draft guidelines for the NHS.
The National Institute for Health and Care Excellence (NICE) is recommending remifentanil, which is a fast-acting morphine-like drug given into a vein.
Women control the medication themselves, by pressing a button to get more of the drug for pain relief. A timer ensures the user cannot administer too much of it.
Women who decide to try remifentanil and do not like it could still decide to have an epidural instead if there is no medical reason why they should not.
They can use gas and air, also called Entonox, which is a mix of oxygen and nitrous oxide, at the same time.
NICE says having remifentanil 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 suggests fewer epidurals might mean fewer births using instruments like forceps and ventouse vacuum suction, says NICE.
Source: BBC News, 25 April 2023