Maternity- and Gynaecology Patient information

Pain Relief in Labour: Epidurals and Remifentanil explained

Epidural Remifentanil PCA

A needle is used (with local anaesthetic) to insert a fine plastic A drip is inserted into a vein in your arm or hand and attached to a patient- What is it? tube between the bones in your back. controlled analgesia (PCA) pump. This contains Remifentanil, a powerful morphine-type drug. The drug itself is used regularly in anaesthetics and An infusion of local anaesthetic and pain killer is given into this was successfully introduced for labour pain relief in in 2013. tube to numb the nerves below your waist, reducing the pain of labour/contractions and causing your legs to feel heavy. You press the button on the pump and a small dose of Remifentanil is given directly into your vein providing pain relief on demand, reducing the severity of labour pain.

To have an epidural you must be on labour ward and be in To use Remifentanil you must be on labour ward and be in established How it is established labour (please discuss this with your midwife). labour (please discuss this with your midwife). used The local anaesthetic infusion gives continuous pain relief. You Press the button every time you have a contraction because each dose of don’t have to do anything. However, you can press a button to Remifentanil wears off within a few minutes. You are the only person that give an extra dose if needed. should press the button. Provides the most complete pain relief of all methods of pain Suitable for women who can’t have epidurals for medical reasons. Benefits relief in labour. Starts working within five minutes of the drip being connected. Women are often able to sleep with an epidural as they have good pain relief. It does not make you drowsy. You may be Remifentanil can pass to your unborn baby (like pethidine) and can cause it able to walk around in the room (mobile epidural) – ask your to be slow to breathe or drowsy at birth. However, remifentanil wears off anaesthetist if you would like to do this. very quickly and has been shown to be safe for babies. Continuous foetal

monitoring is not required unless it has been recommended due to other risk Minimal drug passes to your unborn baby so little newborn factors. drowsiness (unlike pethidine injections). Makes you feel relaxed and sleepy because it is also a sedative. Can be ‘topped up’ for procedures in the operating theatre, for example caesarean section with no extra injections.

Template date: June 2014 1 Leaflet title Pain Rekief in Labour: Epidurals and Remifentanil explained. © Poole NHS Foundation Trust

Contact details Central Delivery Suite

Telephone number 01202 448584

For further general health-related information, please ask the relevant department for an information prescription or contact:

The Health Information Centre Poole Hospital NHS Foundation Trust Road Poole Dorset BH15 2JB Telephone: 01202 448003 www.poole.nhs.uk

Author: Lisa Relton and Caroline Fortescue Date: 06/05/2019 Review date:06/05/2022 Version number: 1.0 Ward sister/head of department: Vicky Garner (Matron for Inpatient Maternity Service)

We can supply this information in other formats, in larger print, on audiotape, or have it translated for you. Please call the Patient Advice and Liaison Service (PALS) on 01202 448499, text 07758 272495 or email [email protected] for advice.

If you wish to make any comments or to ask about any research evidence used to write this leaflet, please contact the Patient Experience team confidentially: phone 01202 448003, write to the Health Information Centre (address above), or email [email protected].

Template date: June 2014 2 Leaflet title © Poole Hospital NHS Foundation Trust