In Australia 78 per cent of labouring women use some form of medication for pain relief. Inhaled nitrous oxide is one of the widely available, used by 53 per cent of women. However, the widespread use of nitrous oxide is currently being reconsidered due to environmental concerns.
Anaesthetists are already deeply involved in obstetric analgesia, providing epidural and remifentanil analgesia. This study presents an opportunity to use our expertise and collaborations to provide preliminary data evaluating nebulised fentanyl as a needle-free and inhaled form of analgesia. Having formulated an evidence-based repeated dosing strategy, further studies will be required to evaluate the full regimen in labouring women. Nebulised fentanyl presents an opportunity to reduce or even eliminate the use of nitrous oxide for this purpose, consistent with the ANZCA Position Statement on Environmental Sustainability PS64(G).
Ultimately, we would like to compare nebulised fentanyl with the existing inhaled nitrous oxide to determine if the two techniques provide equivalent analgesia without causing significant neonatal or maternal side effects. Patient and midwife experiences will also be evaluated. This preliminary research will lead to dosing recommendations and larger clinical evaluations, aiming to provide an additional needle-free, widely available and environmentally friendly option for pain relief during labour.
Associate Professor Victoria Eley, Royal Brisbane and Women's Hospital, Queensland
Dr Christoph Lehner, Royal Brisbane and Women's Hospital, Queensland
Dr Elizabeth Martin, Mater Health, Queensland
Dr Nigel Lee, University of Queensland
Associate Professor Tim Donovan, Royal Brisbane and Women’s Hospital, Queensland
Associate Professor Jayesh Dhanani, Royal Brisbane and Women’s Hospital, Queensland
Professor Jason Roberts, University of Queensland.
The project was awarded $A63,483 funding through the ANZCA research grants program for 2023.