Fenatyl?

celebratelife! · 05-01-2007, 07:15 PM

Hey, has anyone had any experience with this drug? I had a meeting with a momma-to-be today and she said the anesthesiologists mentioned this as a possible drug option for her... She is not able to have an epidural (because of a prior back surgery) and would not have chosen a natural birth. She is mostly concerned about it slowing down labor.

loveslabor · 05-01-2007, 07:25 PM

I don't know about it slowing labor but here's my experience with it:

Personally, I was given fentanyl at some point during my labor (without my knowledge) but I don't remember it actually helping with the pain.

My clients report that it did not help with contraction pain but allowed them to relax more in between the contractions.

In my area, they will only give you 3 shots of fentanyl during labor. And each shot has to be at least 1 hour after the last dose.

CvilleDoula · 05-01-2007, 07:29 PM

Quote:

Originally Posted by loveslabor

I don't know about it slowing labor but here's my experience with it:

Personally, I was given fentanyl at some point during my labor (without my knowledge) but I don't remember it actually helping with the pain.

My clients report that it did not help with contraction pain but allowed them to relax more in between the contractions.

In my area, they will only give you 3 shots of fentanyl during labor. And each shot has to be at least 1 hour after the last dose.

Right, UNLESS they give you a low dose. A regular dose is 50mg I believe. If they give you 25mg, you can have it more often. Either way you're only allowed a certain amount at maximum.

doula Michele · 05-01-2007, 08:39 PM

It is a fast acting drug, but doesn't stay effective for very long.
Here they use it right before an epidural to help mom relax and stay still for the epidural procedure.
Most moms seems to notice a decrease in pain...or I think its moreso that they have the pain, but they just don't give a damn.

DL · 05-01-2007, 09:44 PM

If you read my last post before I deleted it, please disregard. I got mixed up in my mind and was thinking "Phenergan"!

Never mind!

tlcdoula · 05-01-2007, 10:31 PM

I had a mama use it once. She had it on a pump and was able to self administer and she loved it. It was fast acting and didn't stay with her for real long so when she wanted to stop using it then it left her feeling okay much faster then some of the other meds that they give.

Mile High Doula · 05-02-2007, 06:19 PM

Fentanyl is in MOST epidurals so you want to make sure that it will not be in hers. Out here our epidurals are a mixture of Ropivicaine and Fentanyl. If she can't have fentanyl, she can't have an epidural.

Edited: Ok this flu is REALLY getting to my head. I can see she can't have an epidural anyhow.

It's not the fentanyl. Yes, it's short acting and in my experience, does NOTHING for a laboring mom. I had staydol before I had my epidural and it did NOTHING for me. She can try it but she really needs to be focused on having a natural labor instead of what will save her from the pain. Nothing might at this point.

tlcdoula · 05-02-2007, 08:09 PM

Quote:

Originally Posted by Mile High Doula

Fentanyl is in MOST epidurals so you want to make sure that it will not be in hers. Out here our epidurals are a mixture of Ropivicaine and Fentanyl. If she can't have fentanyl, she can't have an epidural.

Edited: Ok this flu is REALLY getting to my head. I can see she can't have an epidural anyhow.

It's not the fentanyl. Yes, it's short acting and in my experience, does NOTHING for a laboring mom. I had staydol before I had my epidural and it did NOTHING for me. She can try it but she really needs to be focused on having a natural labor instead of what will save her from the pain. Nothing might at this point.

I had a client use this with a self controlled pump and it worked wonders for her!!! She would have used only that throughout her entire labor had it not been for the fact that she ended up with a cesarean after getting to 9 cms with a lip that never left.

apikailaa · 05-02-2007, 09:23 PM

This is the only drug that I have had experience with. My client had it in Feb. It didn't really seem to do anything for her except make her light headed. She was only given one dose, and I couldn't really tell when it had kicked in and when it had worn off as it didn't seem to help her pain. She later told me that she wished she had gone for the epidural and that I should have explained pain meds better to her in our prenatals!

It didn't seem to slow or even effect her progression though, first time mom with an 8 hour labor. This is the only drug that one of our doctors uses. I wasn't impressed.

MothertheMother · 05-02-2007, 09:45 PM

from what I understand all narcotics are like this...either it helps or it doesn't but you don't really know until you are in the moment. From what I have read it seems if they get it while in very active labor but not yet transition it can help but if they are already into transition (whether the dilation shows that or not) it doesn't seem to have much of an effect. At least not a positive effect. It seems that the women that say it doesn't help also hate the way it makes them feel between contractions. I experienced this with demerol in my own labor...it seems like it made things worse because I was completely out of it between contractions and only lucid during the pain. After the fact it seemed like the only thing I remembered of that time was the contractions...there was no break for me because I wasn't coherent. I don't assume this happens to all women but I do hear this same story a lot.

ETA: I meant to mention that I did recently read that this drug doesn't seem to have as many negative side effects. It seems to work quickly but doesn't last quite as long (which could be a pro and a con)

wombtowalk · 05-02-2007, 10:33 PM

Epidural anesthesia is regional anesthesia that blocks pain in a particular region of the body. The goal of an epidural is to provide analgesia, or pain relief, rather than complete anesthesia, which is total lack of feeling. Epidurals block the nerve impulses from the lower spinal segments resulting in decreased sensation in the lower half of the body. Epidural medications fall into a class of drugs called local anesthetics, such as bupivacaine, chloroprocaine, or lidocaine. They are often delivered in combination with opioids or narcotics, such as fentanyl and sufentanil, to decrease the required dose of local anesthetic. This way pain relief is achieved with minimal effects. These medications may be used in combination with epinephrine, fentanyl, morphine, or clonidine to prolong the epidural’s effect or stabilize the mother’s blood pressure.

http://www.americanpregnancy.org/lab.../epidural.html

Hope that helps!

celebratelife! · 05-02-2007, 10:40 PM

Thanks everyone! Its so reassuring to have some experiences to share with her. It means so much more than the dry medical explanations.

wombtowalk · 05-02-2007, 10:43 PM

Also, I had a client that was allergic to Nyquil which I guess has fentanyl, so watch out...

emmabella · 05-03-2007, 12:49 AM

I had fentanyl for my labor and the best way I can describe it is it helps you relax. The contractions are more manageable and in between you are pretty much totally out of it. It does not kill the pain it just fiddles with your pain perception. By my third dose it was definitely not working very well though. I've noticed this with doula clients too, after a couple doses it doesn't "stick" like it did with the first. They also typically cut you off of it during transition so that baby has the chance to process the meds and not be born depressed. Having had it myself and seen clients with it, I would never choose it for myself again. I felt it had a serious impact on my son's responsiveness and interest in breastfeeding.

Ceci · 05-03-2007, 12:59 AM

My experience with the drug is varried, some clients like it other hated it. Some used it to get over a hump, others used it early in labor until they were far enough along to get an epidural. Some liked feeling relaxed and said they could still feel the pain but just didn't care while one mom said she hated it b.c she could still feel the pain but was too woozy to get out of bed and change positions or get in the shower.

The other thing to keep in mind is that regardless of the max amount of doses allowed, around here the drug (or any other narcotic) is not given past 7cm so mom may end up loving the drug but not be allowed to have it for the toughest part of labor. Just something to keep in mind.

I am not sure how far along she is but she sounds like a great candidate for hypnobabies if she was willing to consider something like that....