{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:26:30Z","timestamp":1788870390421,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,12,2]],"date-time":"2013-12-02T00:00:00Z","timestamp":1385942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","award":["PB-PG-0407-13170"],"award-info":[{"award-number":["PB-PG-0407-13170"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Western Comprehensive Local Research Network"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Intramuscular (i.m.) pethidine is used worldwide for labour analgesia and i.m. diamorphine usage has increased in the\n                      <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>\n                      in the last 15\u00a0years. This trial aims to ascertain the relative efficacy and adverse effects of diamorphine and pethidine for labour pain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective, parallel\u2010arm randomised controlled trial with blinding of participants, care\u2010givers and outcome assessors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>\n                      Maternity units in two District General Hospitals in the\n                      <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>After written informed consent, 484 women were randomised and recruited (244 diamorphine, 240 pethidine). Inclusion criteria included women 16\u00a0years or older, established labour, singleton pregnancy, 37\u201342\u00a0weeks of gestation and weight 60\u2013120\u00a0kg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>On request of i.m. analgesia, participants received either 150\u00a0mg pethidine or 7.5\u00a0mg diamorphine based on computer\u2010generated block randomisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Maternal\u2014reduction in pain intensity from baseline (10\u2010cm visual analogue scale) at 60\u00a0minutes and over the 3\u2010hour period after drug administration. Neonatal\u2014requirement for resuscitation and Apgar score at 1\u00a0minute.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Diamorphine provided modestly improved pain relief at 60\u00a0minutes, mean difference 1\u00a0cm (95% confidence interval [\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ] 0.5\u20131.5), and over the 3\u00a0hours, mean difference 0.7\u00a0cm (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.3\u20131.1). However, average length of labour in women receiving diamorphine was 82\u00a0minutes longer (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      39\u2013124) and therefore they experienced more pain overall. There were no statistically significant differences in primary neonatal outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is a modest difference between the analgesia provided by diamorphine or pethidine for labour analgesia but diamorphine is associated with significantly longer labours.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.12532","type":"journal-article","created":{"date-parts":[[2013,12,2]],"date-time":"2013-12-02T00:54:56Z","timestamp":1385945696000},"page":"447-456","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["A comparison of intramuscular diamorphine and intramuscular pethidine for labour analgesia: a two\u2010centre randomised blinded controlled trial"],"prefix":"10.1111","volume":"121","author":[{"given":"MYK","family":"Wee","sequence":"first","affiliation":[{"name":"Poole Hospital NHS Foundation Trust Poole UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JP","family":"Tuckey","sequence":"additional","affiliation":[{"name":"Royal United Hospital Bath UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PW","family":"Thomas","sequence":"additional","affiliation":[{"name":"Clinical Research Unit School of Health and Social Care Bournemouth University Bournemouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Burnard","sequence":"additional","affiliation":[{"name":"Royal United Hospital Bath UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,12,2]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Recorded delivery: a national survey of women's experience of maternity care 2006","author":"Redshaw M","year":"2007"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1996.tb09545.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00160.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1970.tb04409.x"},{"key":"e_1_2_6_6_1","first-page":"178","article-title":"The effect of meperidine and promethazine on fetal heart rate indices during the active phase of labor","volume":"4","author":"Solt I","year":"2002","journal-title":"Isr Med Assoc J"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1997.tb08869.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536x.2001.00005.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007396.pub2"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-2011.2011.00061.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1999.tb08145.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2007.05.014"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-11-51"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c869"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00541514"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(86)90228-9"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2001.118863"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1442-2026.2003.00499.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.1996.tb03402.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00131.x"},{"key":"e_1_2_6_21_1","first-page":"56","article-title":"Maternal diamorphine administration during labour: the effect on neonate admissions to NNU","volume":"8","author":"Stirk P","year":"2002","journal-title":"J Neonat Nurs"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0091270010361256"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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