at our hospital (i work level i, ii, & catch babies) we have noticed a trend with stadol and its affects on newborns.
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[color=#483d8b]we get a lot of drop-ins who typically get iv stadol instead of an epidural. the trend seems to be:
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[color=#483d8b]- the more they got
[color=#483d8b]- the closer they got it to delivery (not uncommon to see it
[color=#483d8b] given as little as 11/2 hours or less before delivery :angryfire )
[color=#483d8b]- and if it was combined with phenergan
[color=#483d8b]the more likely the baby is to have trouble.
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[color=#483d8b]the problem is, these babies don't have trouble until later in transition. therefore, giving narcan in the delivery room never happens, because they don't fit the drug-depressed baby scenario. (i have given it later on a few occasions and it did help.)
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[color=#483d8b]these babies scream a lot. they are very irritable. this seems to affect them at delivery in a positive way in that they pink up and often have a second apgar of 10. but later, when they start to tire out, they exhibit periodic breathing and often apnea between periods of screaming. there is little or no 'quiet alert state'. state regulation in these babies is poor. many go on to get dusky and desat. thus, frequently, they at least end up on extended obs. or are (unnecessarily? ... :wakeneo: again) admitted to level ii for dusky spells, then turn out to be fine and go home relatively quickly.
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[color=#483d8b]i feel so sorry for these babies. they must feel like crawling out of their skin or something. they are so irritable they usually won't nurse in the delivery room either.
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[color=#483d8b]has anyone else noticed this, too?