Painkiller could halve number of epidurals

THOUSANDS of mothers could be spared epidurals if doctors switched to a more effective painkiller, a study suggests.

Experts found that remifentanil – a drug barely used by the NHS – was more effective than pethidine, which is given to about 250,000 women a year.

Pethidine is an injection routinely given to around a third of the women who give birth each year in the UK. But about 40 per cent end up needing an epidural anyway.

If remifentanil was more widely used, the researchers suggested, it could slash the number of women who go on to have one by as much as half.

An epidural involves inserting a local anaesthetic into the space between two vertebra in the spine – removing all feeling from the waist down. It can slow down labour and increase the chance of a forceps birth.

Remifentanil is delivered through a drip women can control with a handheld device to coincide with contractions.

The study – led by the universities of Birmingham, Sheffield and Nottingham – found using remifentanil instead of pethidine more than halved the rate of subsequent epidurals from 41 per cent to 19 per cent.

Professor Christine MacArthur, of the University of Birmingham, said there was strong evidence that remifentanil should be routinely offered as an alternative to pethidine.

The findings of the study, published in the Lancet medical journal, were based on 400 women giving birth at 14 UK hospitals.

‘Routinely offered’