N-Allylnormorphine: An antagonist to neonatal narcosis produced by sedation of the parturient

Clinical pharmacology of systemic antidotes

“…In a large series of newborn infants, it was found, for example, that nalorphine increased the necessity for resuscitation among those whose mothers were subjected to ether anesthesia and that it was relatively ineffective when nitrous oxide was used in conjunction with an opiate. 119 In the same study, there was also suggestive evidence that if nalorphine was administered to the mother too far in advance of delivery (more than 25 minutes), the infants were actually slower in estab- lishing respiration than were those whose mothers did not receive the drug. Greene" 73 wisely discourages the routine use of narcotic antagonists in parturient patients and cautions against the indiscriminate use of narcotics under the cover of antagonists.…”

“…The narcotic antagonists, administered either to the mother shortly before delivery or to the infant after birth, have frequently been effective in overcoming neonatal asphyxia caused by narcotic agents administered during labor. 19,63,119,255 It should be emphasized, however, that this form of C'"6 COOC, ", CH 3…”

The Effects of Narcotics on Fetal Acid Base Status

“…NALORPHINE, along with pethidine, morphine and heroin, are now the most commonly administered analgesics in labour (Burt, 1971). Although the effects of the narcotics on mothers and fetuses have been extensively studied, clinical interest has been focused mainly on the respiratory depressant effect of these drugs and its reversal by nalorphine (Eckenhoff et al, 1953;Snider, 1954;Schnider and Moya, 1964;Cappe and Pallin, 1954;Chalmers and Thornberry, 1954;Patterson and Prescott, 1954;Woods, 1956;Campbell et al, 1961;Crawford and Rudofsky, 1965;Adamson and Joelsson, 1966;Becketts and Taylor, 1967;Duncan et al, 1969;Krins et al, 1969;Burt, 1971 ;Becketts, 1973), rather than on other possible side effects. However, laboratory and animal studies have shown that the narcotics may have an inhibitory effect on enzymes of oxidative metabolism and oxygen carrying cytochromes (Wang and Bain, 1953;Gurtner and Burns, 1972), they alter fetal placental perfusion by constricting the umbilical blood vessels (Gautieri and Ciuchta, 1962;Gautieri, 1972), and decrease fetal brain oxygenation (Misrahy et al, 1963).…”

über die Reanimation asphyktischer Neugeborener

“…Der Antagonismus be zieht sich hier vor allem auf die atemdeprcssorische W irkung der Opiate, über dessen gute W irkung zahlreiche Berichte vorliegen [8,26,60]. W ir empfehlen die Anwendung des N-Allyl-Normorphins in der Größenordnung von 0,2-0,4 mg -am besten aufgelöst in 2 ml NaCl intraum bilical.…”