Nalbuphine for obstetric analgesia

Frank, M.; McAteer, E.; Cattermole, R.; Loughnan, B.A.; Stafford, L. B.; Hitchcock, A. M.

doi:10.1111/j.1365-2044.1987.tb05313.x

Cited by 62 publications

(6 citation statements)

References 9 publications

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“…These findings contradict other published results showing greater pain relief after the administration of nalbuphine than of pethidine [6,7]. Our results are however consis tent with a recent prospective study of intramuscular administration of nalbuphine and pethidine during labor [3].…”

Section: Discussioncontrasting

confidence: 57%

Intravenous Pethidine and Nalbuphine during Labor: A Prospective Double-Blind Comparative Study

Dan

Rabinovici²,

Barkai³

et al. 1991

Gynecol Obstet Invest

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The perfect analgesic regimen is constantly sought, no matter how labor is conducted. The quest for an effective drug that will afford maximum relaxation and pain relief with minimum interruption of any natural homeostatic mechanism is a foremost subject in present obstetric analgesics research. Synthetic alternatives are being offered, promising perfect compatibility with the clinician’s demands. Nalbuphine, a semisynthetic narcotic agonist-antagonist analgesic of the penanthren series, is supposed not to be liable to cause respiratory depression and is expected to have fewer side effects. A double-blind, randomised prospective study of 137 patients who received lOmg nalbuphine or 50 mg pethidine i.v. during the active phase of labor in term was carried out. Maternal cardiovascular variables, pain intensity, progress of labor and fetal heart rate during labor were related to side effect and neonatal outcome (1- and 5-min Apgar scores and umbilical venous pH). Neither regimen showed an advantage over the other. Data analysis points to a possible transient depressive effect induced by nalbuphine on the fetal or neonatal central nervous system.

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Section: Discussioncontrasting

confidence: 57%

Intravenous Pethidine and Nalbuphine during Labor: A Prospective Double-Blind Comparative Study

Dan

Rabinovici²,

Barkai³

et al. 1991

Gynecol Obstet Invest

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“…In addition, even where all women appeared to be accounted for at follow-up, there were frequently missing data for specific outcomes. In some studies loss to follow-up or missing data were greater than 10% (Bitsch 1980; Fairlie 1999; Hamann 1972; Levy 1971; Moore 1970; Mowat 1970; Olson 1964; Wilson 1986), or greater than 20% (De Boer 1987; Frank 1987; Giannina 1995; Gillam 1958; Nicholas 1982; O’Dwyer 1971; Refstad 1980).…”

Section: Resultsmentioning

confidence: 99%

Parenteral opioids for maternal pain management in labour

Ullman

Smith

Burns

et al. 2010

Cochrane Database of Systematic Reviews

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“…Previous studies have also reported that there is no meaningful difference in infants' Apgar score. 12,14,16 We were not able to determine the reason for the difference in infant Apgar scores for the first minute between the two groups.…”

Section: Discussionmentioning

confidence: 97%

“…There was no significant difference in blood pressure, heart rate and respiratory rate in the mothers before and after injection (p>0.05), and there was also no significant difference in fetal heart rate before and after injection (p>0.05). In a study by Frank et al (1987) that evaluated the side effects of pethidine on mother and infant, blood pressure, heart rate and respiratory rate in mothers and fetal heart rate and Apgar score in infants were controlled. They concluded that the administration of 75 mg pethidine has no side effects on the mother or her fetus.…”

Section: Discussionmentioning

confidence: 99%

A Randomized, Placebo-Controlled Trial of the Effects of Pethidine on Labor Pain, Uterine Contractions and Infant Apgar Score

2003

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Uterine contractions at the end of pregnancy lead to dilatation of cervix and the expulsion of the fetus from the birth canal. Myometrial contractions are a very painful and unpleasant experience for mothers. The aim of the obstetrician is to decrease the length of labor and labor pains as much as possible by careful control of the phases of labor. In the case of severe labor pains resulting from uterine contractions, the administration of narcotic drugs such as pethidine (meperidine) 1 is indicated. 1Pain and anxiety can affect the progress of delivery by increasing the release of catecholamines and Cortisol. Noradrenaline increases uterine contractions while Cortisol and adrenaline decrease them. In many cases, severe labor pain and anxiety resulting from that can increase the release of adrenaline and Cortisol and lead to a decrease in contractions and consequently a prolonged labor.2 In some cases, pain and anxiety cause ineffective contractions. These contractions are severe with short intervals, but fail to have any progressive effect.2 Pethidine decreases the concentration of catecholamines in blood and by that means seems to increase the speed of delivery. 3Considering the effects of pethidine on cervical smooth muscle and on changes in cervical consistency, 4 as well as previous observations showing the effect of pethidine on the relief of labor pain, we decided to study parturients referred to the obstetrics and gynecology department at Kerman Medical Sciences University Hospital (Kerman, Iran) to obtain a more accurate picture of the effects of pethidine. Patients and MethodsIn this randomized, double-blind clinical trial we sought to determine the effects of pethidine on relief of labor pain, uterine contractions and infant Apgar score. Case (pethidine-administered) and control groups (placeboadministered) were similar in mean age, length of time from marriage to pregnancy, job and place of residency. The required number of subjects, based on a pilot study and considering a power=90%, d=7% and error=5%, was determined as 44 in each group. Subjects were eligible for entry if they were primiparous, had a term-pregnancy (gestational age• 37 weeks), spontaneous labor pains, no narcotic addiction, not a high-risk pregnancy (e.g., preeclampsia, eclampsia, heart-respiratory problems or fetal distress), and at the start of the active phase of delivery (5-cm cervical dilatation) (2).Selected subjects were divided randomly into the case and control groups. The case group received 75 mg pethidine by intramuscular injection 1,3, 5-10 and the control group received the same volume (1.5 mL) of normal saline as a placebo. The first researcher injected patients at the beginning of the active phase (5-cm cervical dilatation). Before injection, the second researcher recorded the vital signs of the mother, including blood pressure, heart and respiratory rate, and the fetal heart rates, duration, and intervals of uterine contractions. The second researcher took the measurements again 45 minutes after injection of pethid...

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Nalbuphine for obstetric analgesia

Abstract: Summary

Cited by 62 publications

References 9 publications

Intravenous Pethidine and Nalbuphine during Labor: A Prospective Double-Blind Comparative Study

Intravenous Pethidine and Nalbuphine during Labor: A Prospective Double-Blind Comparative Study

Parenteral opioids for maternal pain management in labour

A Randomized, Placebo-Controlled Trial of the Effects of Pethidine on Labor Pain, Uterine Contractions and Infant Apgar Score

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