New Anesthetic for Labor and Delivery Holds Promise

Every once in a while, the old saying that “you can’t teach an old dog new tricks” is proven wrong. A recent Yale study has shown that the pain reliever hydromorphone, traditionally used to offer pain relief in post-op can be safely used in an epidural to ease the pain of labor and delivery without some of the undesirable side effects associated with epidurals.

One of the major problems experienced by women who have an epidural to relive pain is that it causes numbing and makes it harder for women to feel the baby emerging. Epidurals currently in common use also make it more difficult for the woman to push.

The reason for this is that epidurals involve using a strong local anesthetic. Put simply, the medicine focuses on reducing feeling in the affected area. Hydromorphone is a more generalized anesthetic which relieves pain without causing the severe numbing which is often experienced with local anesthetics.

Because the pelvic area is not numbed by hydromorphone, women are able to feel it when the baby is born. Pushing is easier because the muscles involved are not numbed by local anesthetic.

Using hydromorphone does not preclude using local anesthetics, but women in the study who received the generalized pain reliever were less inclined to need the local anesthetic. A full 98% of women who were given hydromorphone reported that the drug offered them significant pain relief. Seventy-eight percent of women who received hydromorphone did not need additional local anesthetic during delivery.

In conducting the study, researchers looked for potential side effects associated with other anesthetics used during labor and deliver, including:

  • Lowered blood pressure
  • Slowing down of baby’s heart rate
  • Slow or shallow breathing
  • Sedation
  • Nausea
  • Itchiness

Of the side effects considered, only nausea and itching were observed, and these were only experienced by a small percentage of women involved.

Hydromorphone is significantly diluted when used in labor in delivery. Using the drug in the concentrations typically used after surgery tends to cause nausea for many women (about one third) during delivery. When diluted, only two percent claimed to experience high levels of nausea.

More studies will need to be conducted before hydromorphone is widely used during labor and delivery. However, a limited number of hospitals, notably those in the New Haven, Connecticut area, are beginning to use it as an alternative to local anesthetics.


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