A comparison of fentanyl with pethidine for pain relief during childbirth.

Pethidine is currently the most widely used narcotic administered systemically for the relief of labour pain, but has been shown to have numerous side effects on both mother and neonate. An alternative narcotic, fentanyl when administered intravenously (IV) has been shown to have fewer side effects and a shorter duration of action than does pethidine. There is a lack of research relating to the use of fentanyl administered during labour via alternative routes. Alternative routes have the benefit of being less invasive, requires fewer resources and provides more autonomy to the midwife providing care. This has particular benefits for rural and remote birthing communities. This study will examine the safety and efficacy of fentanyl administered by intranasal (IN) or subcutaneous (s.c) routes for pain relief during childbirth for both mother and neonate. It also will investigate possible maternal and neonatal side effects. Outcomes will be compared with intramuscular (IM) pethidine.