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AMELIA ISLAND, FLA. -- Intrathecal narcotics are easier to use than epidurals, but patients need to be informed that the analgesic effect during labor is not long lasting, Dr. Patricia Fontaine said at the annual meeting of the North American Primary Care Research Group.
Although use of intrathecal narcotics (ITN) remains spotty nationwide, it has become more common, in part because a one-time subarachnoid injection is simpler than epidural catheterization for continuous dosing. Compared with an epidural, ITN analgesia is seen as less likely to interfere with labor, said Dr. Fontaine of the department of family practice and community health at the University of Minnesota, Minneapolis.
Most studies of ITN have been small and have tested it in combination with epidurals, which are usually given on request a couple of hours afterward.
Dr. Fontaine conducted a study of 61 women with uncomplicated singleton pregnancies who were in spontaneous labor at a large urban teaching hospital; 63% of the women were having their first baby. The "classic combination" of morphine and rapid-acting fentanyl was used.
ITN analgesia had ...