Analgesics and Anesthetics Commonly Used in Labor and Birth (Karch, 2015)

Type Drug Usual Effect on Mother Effect on Labor Effect on Fetus or

Dosage/Route Progress Newborn
Narcotic Meperidine 25 mg IV, 50–100 Effective analgesic; Relaxation, possibly Should be given 3 hr
analgesic (Demerol) mg IM q3–4 hr; also feeling of well being aiding progress during before birth to avoid
epidurally cervical relaxation. respiratory depression in
Slows labor contractions newborn. Decreases
if given early. beatto-beat variability in
FHR.
Nalbuphine 10–20 mg IM q3–6 Slowing of respiratory Mild maternal sedation Results in some
(Nubain) hr, 0.3–3 mg/kg over rate; effective analgesic respiratory depression
10–15 min IV
Butorphanol 1–2 mg IM or IV q3- Withdrawal symptoms if Possible slowing of labor Results in some
(Stadol) 4 hr woman is opiate if given early respiratory depression
dependent
Morphine Intrathecally 0,2-1 Pruritus; effective Possible slowing of labor Some respiratory
sulfate mg; 5 mg epidurally analgesia contractions depression
Fentanyl 50–100 µg IM or 25- Hypotension; respiratory Slowing of labor if given May result in respiratory
(Sublimaze) 50 µg IV; also depression early depression
epidurally
Lumbar Local anesthetic Administered for Rapid onset, in minutes; Slowing of labor if given May be some differences
epidural bupivacaine first stage of labor: lasting 60-90 min; loss of early; pushing feeling in response in first few
block (Marcaine), with continuous pain perception for labor obliterated, resulting in days of life
ropivacaine block, anesthesia contractions and birth; possible prolonged
(naropin) will last through possible maternal second stage
birth; injected at L3- hypotension
4; fentanyl or
morphine possibly
added
 Pudendal Local anesthetic Administered just Rapid anesthesia of None apparent None apparent
block lidocaine before birth for perineum
(Xylocaine) perineal anesthesia;
injected trough
vagina
Local Local anesthetic Injected just before Anesthesia of perineum None apparent None apparent
infiltration of lidocaine episiotomy incision almost immediately
perineum (Xylocaine)
General Thiopental Administered IV by Rapid anesthesia; also Forceps required because Results in infant being
intravenous anesthesiologist or rapid recovery abdominal pushing is no born with CNS
anesthetic nurse anesthetist longer possible depression

Sumber: Karch, A. M. (2015). Lippincott’s Nursing Drug Guide. Philadelphia: Lippincott Williams & Wilkins.

Table. Gambaran pengalaman nyeri saat persalinan dan melahirkan

Kala Sensory Affective
Kala I Keram, sakit, nyeri tajam, terasa
Exciting, intens, kelelahan, ketakutan,
berat, nyeri berdenyut, nyeri tertahankan atau tidak tertahankan,
menusuk, seperti diiris, bersifat
distress, menakutkan, menyiksa, tidak
intermiten, terlokalisasi dan global.
dapat digambarkan, luar biasa,
menelan.
Kala II Tekanan menyakitkan, terbakar, Kelelahan, luar biasa, perasaan tidak
merobek, tajam, eksplosif, biasa, tidak fokus, mengerikan, kurang
terlokalisasi. intens.