alternative to pethidine

[Michaelangelo]

I understand there is a new drug alternative to pethidine which is more expensive so doesn't always get offered unless you ask for it, anyone now what it is, how it works and how its different to pethidine?

I had diamorphine with dd1-but not all hospitals offer it. I think it works like pethidine but doesn't cross the placenta so doesn't make the baby drowsy like pethidine. I ended up having an epidural so can't really comment on the effectiveness of diamorphine towards the end of labour.

With dd2, I requested diamorphine-but they said they had run out I said now is not the time to crack jokes - but they really had ran out! [shock Bugger that I thought I'll have pethidine then.

Diamorphine... I know that unprescribed it's a class A drug, its other name being heroin. Pethidine (demerol) is also a class A drug (I think) so don't let that worry you!

How does it work?

Diamorphine hydrochloride belongs to a group of medicines called opioids. Opioids mimic the effects of naturally occurring pain reducing chemicals (endorphins). They combine with the opioid receptors in the brain and block the transmission of pain signals. Therefore, even though the cause of the pain may remain, less pain is actually felt.

IME it makes you sleepy, unpleasantly sick, and kind of uncaring... I think it can slow contractions, as can pethidine... not sure how it affects the baby... google is being annoying! But would think it is slightly better than pethidine as it seems to be the new fangled drug of choice? Someone will come and tell me otherwise now!!

"Pethidine is a pain relieving drug usually given by an injection into the muscle of your leg or buttock. It takes about 20 minutes to work and is effective for around 3 hours.

Pethidine helps you to relax and may lessen the pain of your contractions. It can also speed up your labour, but it does not work for everyone, and it often causes side effects. Vomiting is common after having pethidine, so an anti sickness drug is usually given with it. Other side effects include; feeling shaky, light headed and disorientated. The more of the drug you have, the more likely you are to suffer these effects. The usual dose of pethidine is 100mg, but you may choose to have less.

Pethidine very quickly crosses the placenta and reaches the baby. If you have an injection of pethidine 2 to 4 hours before you deliver, your baby's breathing will be affected and occasionally an antidote needs to be given.

Most babies are fine, but they do tend to be a little more sleepy in the first few days and take longer to establish feeding.

Midwives are able to give pethidine without a doctor's prescription and it is the drug most commonly used, but there are alternatives.

Meptid or Meptazinol

Meptid is similar to pethidine but causes fewer side effects in mother and baby. Nausea and vomiting are the only unwanted effects that still tend to be a problem. Because it does not make you feel sleepy, meptid is often used for women having water-births.

Diamorphine or Heroin

Diamorphine is very effective at relieving pain in labour. It tends to give you a feeling of well being and causes less nausea and vomiting that pethidine.

There is some evidence that babies exposed to diamorphine in the womb, are more likely to become addicted to the drug in later life. For this reason, most Maternity Units do not use it.

The action of any pain relieving drug is unpredictable, and the associated side effects can be a problem. Having said this, many women benefit greatly from having a pain relieving injection during labour. If you are able to choose which injection to have, meptid is probably the best option."

Hope that is enough for you!

Forgot to say after having diamorphine with dd1 - I sat quite happily answering questions on Mastermind!

Both of my deliveries were assisted - dd1 by forceps and dd2 by emergency c-section - I think this was more to do with how they were lying and that they were quite big for my size rather than having pethidine/diamorphine - but I think the stats 'say' there is more chance of having an assisted delivery (but you recover)

Diamorphine knocked me out completely!!!! Lol funny how different it is eh!

For each person I mean..

Thanks Fastasleep a very comprehensive answer! I didn't have pethidine with DS1 as concerned about feeling too "out of it", ended up with epidural and c section so all a bit academic really but thought I might give it a try this time depending on circumtances the meptid sounds like an option I'll look into loca l hospital policy next time I see my midwife. Thanks all for repsonses.