About the service

At East Lancashire Hospitals NHS Trust we have:

  • 16 consultant Obstetric Consultant Anaesthetists leading the service
  • 24-hour resident anaesthetic cover for the Central Birth Suite and our two dedicated obstetric theatres
  • A 24-hour epidural-on-request service (hyperlink to epidural information)
  • 24-hour availability of Remifentanil Patient Controlled Analgesia (PCA) as an option for pain relief in labour

We offer anaesthetic consultation clinics for those with conditions that may affect their anaesthetic options.

Our obstetric anaesthetists also work on the Close Observation Unit together with obstetricians and midwives to look after unwell parents.

In addition:

  • ELHT Obstetric Anaesthetists promote regional anaesthesia (awake anaesthesia) for Caesarean Section
  • ELHT Obstetric Anaesthetists support early and immediate skin-to-skin for new parent and baby whenever possible
  • ELHT Obstetric Anaesthetists support enhanced recovery after Caesarean Section whenever possible

At ELHT, we encourage those in labour to make their own decisions on their pain relief, and we offer the following pharmacological pain relief options:

The common pain relief options for labour are:

'Gas and air' (Entonox)

'Gas and air' (Entonox) - around 30% effective, can be used conjunctions with options 2 and 4. You would need to take gas in during contractions and hold it in.

*Beware of potential environmental impact since nitrous oxide has a global warming potential around 300 times that of carbon dioxide. The nitrous oxide used by women today during labour will remain in the atmosphere for more than 100 years.

Pethidine or Diamorphine injection

Pethidine or Diamorphine injection - around 40% effective. You are allowed up to 2 injections before considering stronger alternatives. Diamorphine is stronger than pethidine.

*Potential side effects are drowsiness, nausea, sickness and slowdown of your breathing.

Remifentanil button (Patient-Controlled Analgesia PCA)

Remifentanil button (Patient-Controlled Analgesia PCA) - ideal if this is not your first pregnancy and you want quick pain relief. Remifentanil PCA is a relatively new option, an ultrashort-acting painkiller, around 100 times stronger than morphine, works within 2-3 minutes and breaks down by your own blood after 2 minutes.

You would need to be put on oxygen when using this, and press the button when you feel a contraction building up. It is less invasive than an epidural as it only involves an extra drip, and can give pain relief up to 70%.

*Potential side effects are drowsiness, nausea, sickness and slowdown of your breathing and a drop of oxygen level in your blood.
(see leaflet below for more information)


"Trust puts East Lancashire mothers in control of their labour pain relief


Epidural - 'gold standard' but also carries risks, takes 30 minutes to put in and 30 minutes to get it working effectively.

1 in 20 chance of failure but if effective, it gives 100% pain relief and can be used for operations if necessary, however it potentially increases the risk of caesarean section.

*Potential risks are headache 24 hours later (1 in 100), failure (1 in 20), bleeding, infection, nerve damage (1 in 24,000 - reversible, to 64,000 - permanent).
(see leaflet below for more information)

A Remifentanil button and an epidural are only available at Central Birth Suite at Burnley General Teaching Hospital.

Further Information about Options for Pain Relief in Labour and Anaesthesia for Caesarean Section can also be found on www.labourpains.com
Labour pains is a website written by a multi-disciplinary group of doctors, midwives and mothers, which ensures that you have access to information which is trustworthy, unbiased and scientifically proven.  It is endorsed by both the Obstetric Anaesthetists’ Association (OAA) and the Royal College of Midwives.

All anaesthetists on the Central Birth Suite will be happy to discuss Epidural Analgesia and Remifentanil PCA with you when you arrive and answer any questions you may have.


Lancashire Women's and Newborn Centre received the Kate Grainger Compassionate Care Award for the 'Immediate skin-to-skin caesarean birth initiative'.

“Lancashire Women and Newborn Centre at Burnley General Hospital, in response to numerous requests for the option of de-medicalised caesareans, the Centre developed a pioneering and fresh thinking approach, and the Trust became the first to formally establish a ‘skin-to-skin’ caesarean standard. The centre was awarded the NHS70 award 2010-2018.”

Useful links and documents:

Remifentanil patient-controlled analgesia (PCA) for women in labour
Anaesthesia for
caesarean section
Anaesthetics and pregnant women with a high body mass index (BMI)
Pain relief in labour