A comparison of intramuscular diamorphine and intramuscular pethidine for labour analgesia: A two-centre randomised blinded controlled trial

Authors: Wee, M.Y.K., Tuckey, J.P., Thomas, P.W. and Burnard, S.

Journal: BJOG: An International Journal of Obstetrics and Gynaecology

Volume: 121

Issue: 4

Pages: 447-456

eISSN: 1471-0528

ISSN: 1470-0328

DOI: 10.1111/1471-0528.12532

Abstract:

Objective: Intramuscular (i.m.) pethidine is used worldwide for labour analgesia and i.m. diamorphine usage has increased in the UK in the last 15 years. This trial aims to ascertain the relative efficacy and adverse effects of diamorphine and pethidine for labour pain. Design: Prospective, parallel-arm randomised controlled trial with blinding of participants, care-givers and outcome assessors. Setting: Maternity units in two District General Hospitals in the UK. Population: After written informed consent, 484 women were randomised and recruited (244 diamorphine, 240 pethidine). Inclusion criteria included women 16 years or older, established labour, singleton pregnancy, 37-42 weeks of gestation and weight 60-120 kg. Methods: On request of i.m. analgesia, participants received either 150 mg pethidine or 7.5 mg diamorphine based on computer-generated block randomisation. Main outcome measures: Maternal - reduction in pain intensity from baseline (10-cm visual analogue scale) at 60 minutes and over the 3-hour period after drug administration. Neonatal - requirement for resuscitation and Apgar score at 1 minute. Results: Diamorphine provided modestly improved pain relief at 60 minutes, mean difference 1 cm (95% confidence interval [CI] 0.5-1.5), and over the 3 hours, mean difference 0.7 cm (95% CI 0.3-1.1). However, average length of labour in women receiving diamorphine was 82 minutes longer (95% CI 39-124) and therefore they experienced more pain overall. There were no statistically significant differences in primary neonatal outcomes. Conclusions: There is a modest difference between the analgesia provided by diamorphine or pethidine for labour analgesia but diamorphine is associated with significantly longer labours. © 2013 Royal College of Obstetricians and Gynaecologists.

https://eprints.bournemouth.ac.uk/22219/

Source: Scopus

A comparison of intramuscular diamorphine and intramuscular pethidine for labour analgesia: a two-centre randomised blinded controlled trial.

Authors: Wee, M.Y.K., Tuckey, J.P., Thomas, P.W. and Burnard, S.

Journal: BJOG

Volume: 121

Issue: 4

Pages: 447-456

eISSN: 1471-0528

DOI: 10.1111/1471-0528.12532

Abstract:

OBJECTIVE: Intramuscular (i.m.) pethidine is used worldwide for labour analgesia and i.m. diamorphine usage has increased in the UK in the last 15 years. This trial aims to ascertain the relative efficacy and adverse effects of diamorphine and pethidine for labour pain. DESIGN: Prospective, parallel-arm randomised controlled trial with blinding of participants, care-givers and outcome assessors. SETTING: Maternity units in two District General Hospitals in the UK. POPULATION: After written informed consent, 484 women were randomised and recruited (244 diamorphine, 240 pethidine). Inclusion criteria included women 16 years or older, established labour, singleton pregnancy, 37-42 weeks of gestation and weight 60-120 kg. METHODS: On request of i.m. analgesia, participants received either 150 mg pethidine or 7.5 mg diamorphine based on computer-generated block randomisation. MAIN OUTCOME MEASURES: Maternal-reduction in pain intensity from baseline (10-cm visual analogue scale) at 60 minutes and over the 3-hour period after drug administration. Neonatal-requirement for resuscitation and Apgar score at 1 minute. RESULTS: Diamorphine provided modestly improved pain relief at 60 minutes, mean difference 1 cm (95% confidence interval [CI] 0.5-1.5), and over the 3 hours, mean difference 0.7 cm (95% CI 0.3-1.1). However, average length of labour in women receiving diamorphine was 82 minutes longer (95% CI 39-124) and therefore they experienced more pain overall. There were no statistically significant differences in primary neonatal outcomes. CONCLUSIONS: There is a modest difference between the analgesia provided by diamorphine or pethidine for labour analgesia but diamorphine is associated with significantly longer labours.

https://eprints.bournemouth.ac.uk/22219/

Source: PubMed

A comparison of intramuscular diamorphine and intramuscular pethidine for labour analgesia: a two-centre randomised blinded controlled trial

Authors: Wee, M.Y.K., Tuckey, J.P., Thomas, P.W. and Burnard, S.

Journal: BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY

Volume: 121

Issue: 4

Pages: 447-454

eISSN: 1471-0528

ISSN: 1470-0328

DOI: 10.1111/1471-0528.12532

https://eprints.bournemouth.ac.uk/22219/

Source: Web of Science (Lite)

A comparison of intramuscular diamorphine and intramuscular pethidine for labour analgesia: a two-centre randomised blinded controlled trial.

Authors: Wee, M.Y.K., Tuckey, J.P., Thomas, P.W. and Burnard, S.

Journal: BJOG : an international journal of obstetrics and gynaecology

Volume: 121

Issue: 4

Pages: 447-456

eISSN: 1471-0528

ISSN: 1470-0328

DOI: 10.1111/1471-0528.12532

Abstract:

Objective

Intramuscular (i.m.) pethidine is used worldwide for labour analgesia and i.m. diamorphine usage has increased in the UK in the last 15 years. This trial aims to ascertain the relative efficacy and adverse effects of diamorphine and pethidine for labour pain.

Design

Prospective, parallel-arm randomised controlled trial with blinding of participants, care-givers and outcome assessors.

Setting

Maternity units in two District General Hospitals in the UK.

Population

After written informed consent, 484 women were randomised and recruited (244 diamorphine, 240 pethidine). Inclusion criteria included women 16 years or older, established labour, singleton pregnancy, 37-42 weeks of gestation and weight 60-120 kg.

Methods

On request of i.m. analgesia, participants received either 150 mg pethidine or 7.5 mg diamorphine based on computer-generated block randomisation.

Main outcome measures

Maternal-reduction in pain intensity from baseline (10-cm visual analogue scale) at 60 minutes and over the 3-hour period after drug administration. Neonatal-requirement for resuscitation and Apgar score at 1 minute.

Results

Diamorphine provided modestly improved pain relief at 60 minutes, mean difference 1 cm (95% confidence interval [CI] 0.5-1.5), and over the 3 hours, mean difference 0.7 cm (95% CI 0.3-1.1). However, average length of labour in women receiving diamorphine was 82 minutes longer (95% CI 39-124) and therefore they experienced more pain overall. There were no statistically significant differences in primary neonatal outcomes.

Conclusions

There is a modest difference between the analgesia provided by diamorphine or pethidine for labour analgesia but diamorphine is associated with significantly longer labours.

https://eprints.bournemouth.ac.uk/22219/

Source: Europe PubMed Central

A comparison of intramuscular diamorphine and intramuscular pethidine for labour analgesia: a two-centre randomised blinded controlled trial.

Authors: Wee, M.Y., Tuckey, J.P., Thomas, P. and Burnard, S.

Journal: BJOG: An International Journal of Obstetrics & Gynaecology

Volume: 121

Issue: 4

Pages: 447-456

ISSN: 1470-0328

Abstract:

Intramuscular (i.m.) pethidine is used worldwide for labour analgesia and i.m. diamorphine usage has increased in the UK in the last 15 years. This trial aims to ascertain the relative efficacy and adverse effects of diamorphine and pethidine for labour pain.

https://eprints.bournemouth.ac.uk/22219/

Source: BURO EPrints