New drug will deliver pain relief to women in labour who don’t want an epidural 

Women going into labor are being offered a new type of patient-controlled pain relief as an alternative to an epidural.

The fast-acting opioid reminfentanil may be offered to those who want continued pain relief during labor but don’t want an epidural, according to updated design guidelines from the National Institute for Health and Care Excellence (Nice).

It said that since women control the medication themselves, they may be able to be more mobile than with an epidural.

Meanwhile, the updated draft guideline states that Tens devices are not provided by the NHS, but that working women can use their own devices if they wish. However, they should be advised ‘there is very little evidence of its effectiveness in established labour, but no evidence of harm’.

Reminfentanil is introduced into the bloodstream through a tube.

A machine containing the drug is connected to this tube, and women during labor can self-administer the pain relief as needed. A timer connected to the machine ensures that they can’t have too much.

Nice said that compared to opioids given by and injection, reminfentanil has been shown to reduce the use of epidural — an injection of medication into the back that stops women from feeling pain in the lower half of the body.

There is also a reduced chance of birth with forceps or ventouse.

It comes after a number of hospitals have halted the use of gas and air as a method of pain relief during labor due to concerns about medical staff being exposed to nitrous oxide for extended periods of time.

The updated Nice guidelines also suggest where women should choose to give birth.

Those who are overweight — with a body mass index score of 25 or higher — should be aware that they and their baby may be at increased risk in childbirth and should “consider this when planning their birthplace,” it said.

The new Nice draft directive is open for consultation until 6 June.