Stadol and Narcan Question - page 2

How many of you automatically give a baby Narcan immediately after delivery from a mother who was only given Stadol IV in labor?... Read More

  1. by   layna
    I just tell people to refer to the NRP guidelines regarding Narcan use...there are less invasive ways of stimulating a baby instead of using a needle stick of Narcan! :-)
  2. by   sbic56
    Originally posted by layna
    I just tell people to refer to the NRP guidelines regarding Narcan use...there are less invasive ways of stimulating a baby instead of using a needle stick of Narcan! :-)
    Holy crap. Are you saying you know nurses who use it mainly for the needle stimulous? Just grab the vitamin K in that case.
  3. by   HazeK
    I've given Stadol...only to have the multip deliver <30" later....
    ("Stadol inductions" is the cliche)

    I've never had a depressed baby that required ventalatory support,
    BUT here is the rationale for NOT giving Narcan, per our NICU crew:

    Narcan is short acting...
    If given for resp depression after narcotic administration, yes, the baby will perk right up.....but it very likely will 'crump' again in <1 hr up in the regular nursery, as the Narcan typically wears off before the narcotic effects!
    The NICU crew would much rather give resp support until the narcotic effects are gone and then "graduate" the baby to reg. nursery than have a kiddo in nursery "flunk" to NICU .... and scare the crap out of the parent or reg nursery staff!!!
  4. by   at your cervix
    Sorry, I guess I should have been more specific, when I have a RESPIRATORY DEPRESSED infant, I give Stadol and it works and no, I don't just give it for the needle stick, I am aware of the less invasive ways to stimulate a baby!
  5. by   ShandyLynnRN
    But, as I said before.... narcan isn't supposed to affect stadol. Does anyone else have any input on this? I haven't researched it or anything, but this is just what I was taught. That because stadol isn't an opioid, that narcan won't affect it since narcan acts on opioods.
  6. by   sbic56

    Narcan is effective at blocking the synthetic narcotic Stadol at the receptor site, just as it is with true opiods. The fact that it is a synthetic narcotic doesn't make a difference as the receptors bind with the Narcan, thus blocking the effect of the Stadol, Demerol, MS, Nubain...whatever.
  7. by   mark_LD_RN
    talk with the drug rep's and learned something new. even though stadol and nubain are narcotic antagonist's stadol does reverse their effect.
    also they verified that narcotics like demerol should not be given close to stadol or nubain as they cancel each other out.

    I worked with a nursery nurse that would give narcan just for the stimulation of the needle stick even if mom recieved no other pain meds!
  8. by   layna
    I think that we all need to keep the NRP guidelines in mind regarding Narcan and understand that Narcan is not a benign has side effects like all other meds. I believe in avoiding the administration of medications unless indicated.

    What is confusing our staff is the nature of Stadol. In our nursing drug books, it says that the treatment of Stadol overdose is Narcan. They assume that the baby is born with an overdose (since we give Mom Stadol 1-2mg q1-2h IVP) before he has a chance to show symptoms. I think NRP hits the nail on the head. Before you give Narcan, make sure that you meet the criteria outlined in NRP.
  9. by   mark_LD_RN
    exactly Layna. narcan is not a resucitation is to be given for resp depression r/t drugs. I tend to go by NRP guidelines.
  10. by   sbic56
    Another thing to consider is that if Narcan is given and then the neonate perks up, it can crump in an hour when the effects wear off....just a "beware."