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[yogenbhatt1]

There are times when we are trapped due to non action of epidural or very late call for an epidural, or technical difficulty in giving one.
Can one recommend a good alternative that can be given  I V?

[jafo1964]

no experience
but i presume scientifically speaking
you could use the shortest acting mu opioid receptor pure agonist - remifentanyl or fentanyl
Risk of foetal depression is expected and can be managed with paediatrician on standby with naloxone and airway access devices if necessary

But why not consider an inhalational alternative
Entonox is touted to be an excellent alternative to CLEA

[yogenbhatt1]

WE have been using 20 mcg of Inj. Fentanyl( Other molecules are not available in India) Sufentanyl is there but very difficult to acquire.
WE give 20 mcg Fentanyl IV and keep the rest of 80 mg diluted in a syringe. We keep giving it IV as 2 or 3 mcg demand dose. I have never connected a syringe pump on a patient in labour, that too a late stage. So we keep giving demand dose only.
It has worked well, though  not sufficient experience to present it.
In no case there was foetal dystress. Though we keep Nalox available.
Can any one present their experience.
Gases like Entonox are only heard of over here.
 I did read about Sevo for labour. Will try it out.