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Obstetrics

Spinal narcotics for labor

Spinal, or intrathecal, narcotics for labor (ITNL) is a method of pain management for mothers in labor. It is designed to provide comfort during the first stage of labor (until the baby is ready to come out) in a safe, reliable and quick manner. It also enables the mother to help "push" the baby out when she is ready to deliver.

How ITNL is delivered

Once the mother is having a good pattern of labor, a member of the anesthesia staff can be called to place the spinal narcotics. After a brief period of inquiry, examination and discussion, the mother positions herself in either a sitting or sideways lying position. Her back is then cleaned and draped and a small amount of anesthetic (numbing medicine) is injected into the skin of the lower back. Through this now-numb area of skin a narrow needle is inserted until the spinal canal is reached. A tiny amount of spinal narcotics is then injected and the needle is withdrawn. Pain relief is usually evident within a few minutes and typically lasts for several hours and often for the duration of labor. After delivery, spinal narcotics are reversed with a one-time dose of medicine.

Advantages

Unlike the epidural or other forms of pain management for labor, spinal narcotics offer these advantages:

  • Quicker onset of pain relief.
  • One relatively quick injection of medicine.
  • No catheters, pumps or other encumbering devices.
  • Much less medicine is delivered to the mother and fetus.
  • No slowing-down of the progress of labor.
  • Less increase in chances for a cesarean section.
  • The mother is able to participate in "pushing" the baby out.
  • Less chance of decrease in the mother's blood pressure.
  • Smaller needle diameter.
  • Lower incidence of headache.
  • Less chance for backache.

Other effects

Spinal narcotics have been associated with some potential side effects. Most mothers will experience some itching after receiving these medications. Nausea and/or vomiting can occur. Depression of breathing is a potentially serious but rare side effect. Post-delivery headache or backache occur rarely.

Contact information

For more information, please call the obstetrics department at 513.524.5477.

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