Intramuscular diazepam in labour. A double-blind trial in multiparae. A comparative study of intramuscular ketorolac and pethidine in labour pain. Librium for patients in labor. Chlordiazepoxide in labor. Its effect on the newborn infant. Comparison of hydroxyzine-meperidine and promethazine-meperidine for analgesia during labor. [Determination of diazepam concentration in maternal and fetal serum after intravenous administration during active phase of labor and its effects on neonates]. [Effect of diazepam on fetus after intravenous administration during the active phase in labour]. Lorazepam premedication for labour. A CLINICAL EVALUATION OF INTRAVENOUS DIMENHYDRINATE IN LABOUR. A controlled study on effect of promethazine hydrochloride and meperidine hydrochloride upon serum billirubin levels in the newborn infant. Effect of diazepam on meperidine requirements of patients during labor. Drotaverine hydrochloride for augmentation of labor. Effect of hyoscine-N-butyl bromide rectal suppository on labor progress in primigravid women: randomized double-blind placebo-controlled clinical trial.
Diazepam 0.2 mg/kg, diazepam 0.3 mg/kg or a placebo were administered i.m., during labour, in a double-blind fashion to 28 multiparous patients. Although there were no significant differences in the requirements for i.m. pethidine during labour, diazepam was associated with a superior quality of pain relief. Diazepam 0.3 mg/kg i.m. produced no obvious adverse effects upon the neonate. A single dose block randomised double-blind study comparing intramuscular ketorolac, 50 mg of pethidine and 100 mg pethidine was carried out in multiparous women. Pain intensity and sedation effect were recorded at inclusion to the study, half hourly for the first 2 h, then hourly until 6 h after delivery. Maternal and neonatal side effects were noted including the Apgar scores and the baby's requirements for resuscitation. All three treatments are relatively ineffective in relieving labour pain. There was no difference in the analgesic efficacy between the two doses of pethidine but both doses of pethidine were statistically more effective compared with ketorolac. There was no difference in the retrospective assessment of the three groups or when comparison was made with the previous labour. A similar number of patients required further analgesia in each group. In all three groups, no adverse effect occurred in the mother or fetus. Maternal sedation and fetal depression were statistically less in the ketorolac group. Although ketorolac had inferior analgesic effect, its use was not associated with clinically significant sequelae and it showed a superior safety profile compared with either dose of pethidine. The study was not powerful enough to detect a difference between 50 mg and 100 mg of pethidine. nan nan nan To investigate the effects of diazepam on the neonates administered intravenously during the active phase in labour.
                Sixty normal term parturients during the active phase of labour with the cervical dilatation to 3-5 cm were randomly divided into two groups, study group (n = 30) and control group (n = 30). In study group 10mg diazepam was administered intravenously. The concentrations of diazepam and demethyldiazepam in maternal and cord serum were measured by high performance liquid chromatography and neonatal arterial blood gas and Apgar scoring were determined immediately after birth.
                At delivery, the mean level of diazepam in umbilical cord serum was 947 +/- 314 micrograms/L, markedly higher than that of maternal serum which was 488 +/- 300 micrograms/L, while the mean levels of demethyldiazepam were not significantly different in maternal and fetal serum. There was no marked difference between the two groups in fetal arterial blood gas and acidbase status. However, the rates of respiratory depression and muscle tone inhibition in the neonates of study groups (63.3% and 26.7% respectively) were significantly higher than those in the control group (30% and 3.3% respectively) (P < 0.05, P < 0.01).
                Use of diazepam in pregnant women during active phase of labour may cause depression of neonatal respiration. To investigate the effects of diazepam on fetal heart rate and Apgar scoring administered intravenously during the active phase in labour, sixty-two normal term parturients during the active phase of labour with the cervical dilation to 3-5 cm were randomly divided into two groups, diazepam group (n = 32) and control group (n = 30). In diazepam group, 10 mg diazepam was administered intravenously. The concentrations of diazepam in maternal and cord serum were measured by high performance liquid chromatography after birth and the fetal heart rates were monitored by electronic monitor before or after administration of diazepam and Apgar scores were determined immediately after birth. The results showed that the mean level of diazepam in umbilical cord serum was markedly higher than that of maternal serum. Fetal heart base line mutation in diazepam group was weaker than that of the control group. Apgar scores in the neonates of diazepam group was lower than those of the control group. The results indicate that the use of diazepam in pregnant women during active phase of labour may cause depression of fetus. Fifty primigravidae were given either lorazepam (2 mg) or identical dummy tablets in early labour, in a randomized double-blind fashion. Analgesia (standardized at pethidine 100 mg) was given as required, and pain relief was assessed by visual analogue scale. Analgesia was significantly better in those mothers who had received lorazepam. There was a higher incidence of respiratory depression at birth in the infants in this group, although this was not statistically significant. Patients given lorazepam were all satisfied with their analgesic regimen compared with half of those given an inactive tablet. There was a higher incidence of amnesia for labour in the active group. There is a need for a similar study of the effects of other drugs which are given to supplement pethidine in labour. Dimenhydrinate was administered intravenously to patients in spontaneous labour in order to evaluate its effect on the length of labour, its analgesic property, its potentiation of the effects of standard analgesics and its overall safety. The results of this study provided no evidence that labour was shortened or that uterine activity was increased in those receiving intravenous dimenhydrinate, nor did this drug decrease the need for conventional analgesics. There were no maternal or fetal complications. It is concluded that intravenous administration of dimenhydrinate has no advantage over analgesics administered by other routes and has a limited use in current obstetrical practice. nan nan To study the use of drotaverine hydrochloride for acceleration of labor and relief of labor pains.
                In this double-blind placebo-controlled randomized study, 100 primigravidas in uncomplicated spontaneous labor at term were given drotaverine hydrochloride or placebo (distilled water) intramuscularly. Labor events, including pain (assessed by a visual analog scale and a verbal rating scale), neonatal outcome, and side effects of the drug were recorded. Student's t-test was used for analysis.
                Forty-four patients in the drug group and 40 in the placebo group had complete data for analysis after decoding. In drotaverine group, there was a mean 15% reduction in the duration of the first stage of labor and a mean 19% reduction in the second stage. The maximum shortening of the first stage (28%) was observed when drotaverine was administered when cervical dilatation was 4 cm (P=0.044). There were no adverse fetal effects, but atonic postpartum hemorrhage was more common in the drotaverine group. There was no relief of pain with the drug except in the fourth stage of labor.
                Drotaverine hydrochloride is safe and effective in accelerating labor, but not effective in lessening labor pain. To determine the effects of hyoscine-N-butyl bromide (HBB) rectal suppository on labor progress in primigravid women.
                A randomized double-blind placebo-controlled clinical trial was carried out on 130 primigravid women admitted for spontaneous labor. The women were recruited based on the inclusion and exclusion criteria and randomized into the experimental (n=65) and control group (n=65). In the beginning of the active phase of labor, 20 mg of HBB rectal suppository was administered to the experimental group, while a placebo suppository was administered to the control group. Cervical dilatation and duration of active phase and second stage of labor were recorded.
                The rate of cervical dilatation was 2.6 cm/h in the experimental and 1.5 cm/h in the control group (P<0.001). The active phase and the second stage of labor were significantly shorter in the experimental group (P=0.001 and P<0.001, respectively). There was no significant difference between the two groups in the fetal heart rate, maternal pulse rate, blood pressure, and the APGAR score 1 and 5 minutes after birth.
                Use of HBB rectal suppository in the active management of labor can shorten both the active phase and second stage of labor without significant side-effects.
Overall, the findings of this review demonstrated insufficient evidence to support a role for non-opioid drugs on their own to manage pain during labour.