Judith Kurokawa received her BSN from Montana State University in 1978, her certificate as a family nurse practitioner from the University of North Dakota in 1982, and her certificate in nurse midwifery from Educational Programs Associates/San Jose in 1988. She serves as a preceptor for Community Nurse-midwifery Education Program (CNEP) students. She is currently employed at Listerud Rural Health Clinic in Wolf Point, Montana providing family health care as a CNM and FNP.
USE OF INTRATHECAL ANALGESIA IN A RURAL HOSPITAL: Case Studies
Article first published online: 6 JAN 2011
1996 American College of Nurse Midwives
Journal of Nurse-Midwifery
Volume 41, Issue 4, pages 338–342, July-August 1996
How to Cite
Sinquefield, G., Kurokawa, J. S. and Zilkoski, M. W. (1996), USE OF INTRATHECAL ANALGESIA IN A RURAL HOSPITAL: Case Studies. Journal of Nurse-Midwifery, 41: 338–342. doi: 10.1016/0091-2182(96)00035-3
- Issue published online: 6 JAN 2011
- Article first published online: 6 JAN 2011
A woman's experience of unrelenting back pain with a fetus in an occipitoposterior position and the escalating interventions culminating in a cesarean birth is every midwife's nightmare. Intrathecal analgesia is a relatively simple and rapid method to provide maternal relaxation and relief from severe back labor. This article describes the use of intrathecal opioid analgesia in labor complicated by failure to progress in first-stage labor due to persistent occipitoposterior position of the fetus. Intrathecal analgesia has the advantage of being inexpensive and providing rapid onset of adequate pain relief for the first stage of labor. It does not cause motor blockade, so it allows the mother to be mobile and feel the urge to push. Consequently, there is no associated risk of an increased need for forceps or vacuum-assisted delivery. The authors note a decreased incidence of operative delivery for fetal occipitoposterior position with the use of intrathecal narcotics.