Subcutaneous fentanyl for labour analgesia: a retrospective case note review. (February 2021)

• Record Type: Journal Article
• Authors: Fleet, J.; Sok, C.; Randall, E.R.; Cyna, A.M.
• Is Part Of: International journal of obstetric anesthesia. Volume 45(2021)
• Page Start: 138
• Page End: 141
• Publication Date: 2021-02
• Subjects: Fentanyl -- Labour analgesia -- Subcutaneous; Obstetrics -- Periodicals; Anesthesia -- Periodicals; Anesthésie en obstétrique -- Périodiques; Anesthesia; Obstetrics; Electronic journals; Periodicals; 617.9682
• DOI: 10.1016/j.ijoa.2020.10.009
• Languages: English
• ISSNs: 0959-289X

Abstract

Highlights: Subcutaneous fentanyl is effective for labour analgesia. Fentanyl has the advantage that it can be administered by less invasive methods. Neonatal outcomes were not impacted by subcutaneous fentanyl for maternal analgesia. Abstract: Background: In 2017, a South Australia Perinatal Practice Guideline was introduced state-wide for the use of subcutaneous fentanyl for labour analgesia as a replacement for intramuscular pethidine. We retrospectively reviewed the implementation of this practice change in our institution. Methods: A retrospective review of maternal and neonatal case notes for the first 100 women administered subcutaneous fentanyl in labour at a single tertiary referral centre for maternity care, between February and June 2017. Results: Of the 102 women administered subcutaneous fentanyl, the majority (55%) were primipara, with an average maternal age of 29 years and body mass index of 27 kg/m 2 . The median total fentanyl dose administered was 200 µg and the average time from last dose to birth was 3 h. The majority of women (70%) did not require additional rescue labour analgesia and 80% had a spontaneous vaginal birth. All neonates had a 5-min Apgar score >7. The median Apgar score at 1 and 5 min was 9. No neonate had an arterial cord blood pH <7.1. The mean arterial and venous cord blood pH was 7.3. The average time for neonates to establish breathing was 1 min and the median postnatal length of stay was two days. Conclusions: Subcutaneous fentanyl for labour analgesia appears effective and has a low incidence of adverse events.