Labour Ward Analgesia


  • Aim to provide labour analgesia within 30minutes of request (from midwife request)
  • There are no ‘early’ or ‘late’ limits for when to perform regional anaesthesia in labour
  • ODP to assist in room
  • Case midwife should have the following ready:
    •  IV access
    •  CADD pump for patient/midwifery controlled epidural analgesia
    •  CADD pump tubing
    •  100mcg Fentanyl ampoule


  • CSE is commonly performed
  • Default kit is Braun but Portex kit also available if requested from ODPs
  • Suggested dose: 1ml 0.25% plain Marcaine plus 25mcg Fentanyl
  • Epidural pump to be connected to patient end with a second witness
  • Midwife controlled bolus
  • 9mls bolus, lockout 15min (default setting on pump)


  • Not routinely offered to patients
  • Is an option in situations such as IUD, sickle cell crisis, post GA LSCS
  • Pumps are the same as ones used in HH
  • Labour ward PCA policy currently being reviewed
  • Midwives are not trained to set up PCA – we will be asked to do so.  Once set up – PCA patient MUST have one to one midwife