Obstetric Meperidine Usage and Assessment of Neonatal Status

Brackbill, Yvonne; Kane, James J.; Manniello, R. L.; Abramson, David C.

doi:10.1097/00000542-197402000-00004

Cited by 104 publications

(22 citation statements)

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“…The Scanlon behavioural score, performed at 12-24 hours under double-blind conditions, indicated that there were no differences between the four groups. This differs from the findings of Brackbill et al (1974), and may be due to the small numbers, to the timing, or to the subjective nature of the test. More objective tests such as those adopted by Wiener et al (1977) to assess feeding, sucking, and habituation to an auditory stimulus are probably more accurate and reliable.…”

Section: Discussioncontrasting

confidence: 81%

Effects of pethidine and its antagonists on the newborn.

Brice¹,

Moreland²,

Walker³

1979

Archives of Disease in Childhood

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SUMMARY Nalorphine and naloxone were compared as to their effectiveness as pethidine antagonists. 85 infants were divided into a control group comprising 19 newborn babies whose mothers did not receive pethidine and the babies received no antagonist, and three groups in which the mothers all received pethidine and the babies had either no antagonist (24), nalorphine IV (16), or naloxone IV (26). All the babies were assessed by measuring their neurobehavioural states and respiratory functions. A further 12 newborn babies had naloxone plasma levels measured by radioimmunoassay. Although standard doses of nalorphine effectively antagonised the depressive effect on respiration induced by pethidine, there was a pronounced and undesirable excitatory agonist action. Naloxone was not observed to have any agonist activity, but the recommended IV dose (0.01 mg/kg) had only a slight and delayed antagonist action as measured by respiratory function tests. A more rapid and improved antagonism was noted after this dose was doubled (0 02 mg/kg). The plasma elimination-phase half-life of naloxone after intravenous cord injection was about 3 hours.

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Section: Discussioncontrasting

confidence: 81%

Effects of pethidine and its antagonists on the newborn.

Brice¹,

Moreland²,

Walker³

1979

Archives of Disease in Childhood

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“…Administration of pethi dine to a woman in labor might slow down her infant's recovery from birth asphyxia [4], lead to lower oxygen saturation and prolong the time to sustained normal res piration [5], In evaluating new analgesics for possible use during labor, it is important to take into account the route of administration. In the present study we admin istered nalbuphine or pethidine via the intravenous route according to the recommended effective dosage, with the object of rapidly achieving adequate peripheral levels and providing the maximum benefit from the drug during labor.…”

Section: Discussionmentioning

confidence: 99%

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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“…Although cord compression cannot be ruled out, in the present and the previously studied infants normal fetal heart rate rapidly returned following administration of oxygen to the mother. Further, infants born with evidence of hypoxia or neonatal suppression following the administration of meperidine during labor may not represent all affected infants since infants of these mothers may demonstrate a 10-15% reduced minute volume up to several hours after birth (14), a reduced percent oxygen saturation during the first 30 min of life (19), and depressed psychophysiologic responses be tween 20 and 60 h after birth (2). Although infants with some evidence of hypoxia or neo natal suppression do well and are discharged from the hospital with their mothers, long term follow-up is required to learn if these infants will be identified later as children with learning disorders or other syndromes that might be related to 'minimal brain damage'.…”

Section: Discussionmentioning

confidence: 99%

Cord and Maternal Serum Meperidine Concentrations and Clinical Status of the Infant

Rothberg¹,

Rieger²,

Hill³

et al. 1978

Neonatology

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The possible relationship between the use of meperidine during labor and fetal or neonatal distress was investigated by correlating clinical parameters with maternal and cord serum concentrations of meperidine. The serum concentration of meperidine was determined by a radioimmunoassay which is 100-fold more sensitive than previously employed techniques and can detect as little as 0.02 nmol meperidine/ml. The incidence of fetal or neonatal depression following meperidine administration was higher (6 of 17 infants) than in a control group but no correlation between suppression and the route of meperidine administration or the serum meperidine concentrations at the time of delivery was found.

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Obstetric Meperidine Usage and Assessment of Neonatal Status

Cited by 104 publications

References 0 publications

Effects of pethidine and its antagonists on the newborn.

Effects of pethidine and its antagonists on the newborn.

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

Cord and Maternal Serum Meperidine Concentrations and Clinical Status of the Infant

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