Stadol Screamers

Specialties Ob/Gyn

Published

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?

Specializes in OB, lactation.
much to my dismay, at our hospital they don't encourage the mothers to walk - docs want them on the monitors. the l&d staff (save a few) don't bother to teach non-pharm. pain relief measures.

basically no one on our unit walks unless they are an outpatient labor check that's just going to walk around the hospital an hour or two and then let us look again to see if she's making change. they pretty much all come in and get immediately and permanantly strapped to the monitor, and most don't know any better :(

we don't give stadol late in labor for the aforementioned reasons, so no one still has it floating around in their system when they are complete unless their cervix just melted away faster than we anticipated :)

Specializes in OB, lactation.
because of the risks of an epidural dropping mom's blood pressure to the point of fetal distress when it is first started, and thus the potential need for a stat section, they want the docs in house. (it's gonna drop her pressure, it's just a matter of how much - which you don't know ahead of time)

we are small enough of a hospital that we don't usually have an ob or a neo in house routinely at night.

we are a community hospital and we don't even have in-house ob all the time in the daytime, much less at night, but moms still get their epidurals.

ps... we don't have any neonatologists at any time - if a baby has those needs, they get flown out.

I had stadol with my first labor 16 years ago - that stuff should be BANNED!!!

It was absolutely awful, did not help with the pain and I think it made the whole experience worse than it had to be.

I ended up having to have a crash section and honestly don't know exactly how his transition went - my husband is a very poor historian. I do know that nursing did not go well after I finally came around.

:yeahthat:

I thought that the Stadol was a "good" thing at first but then quickly changed my tune afterward. I was terribly unfocused, sad, yadda yadda. I had this beautiful baby girl and didn't "know what do do about it!!":uhoh21:

When my minister (at the time) came to visit me, I broke down in tears for no apparent reason!

I was afraid to hold my daughter, change her diaper, etc. Breastfeeding in the hospital was sporadic, at best. She didn't want to nurse. I felt inadequate. I had to fib when the nurses did their newborn assessments. They'd ask how long she nursed on each side, and I always gave a "good" number...:jester:

It took nearly two weeks for me to "become focused" once I arrived back on the homestead. I later attributed this to having the "baby blues," not true postpartum depression, with "a little bit of Stadol crap mixed in...":bugeyes:

My two subsequent births went better. Of course, they, two, were scheduled C sections, but I just had PAIN, not PAIN AND CONFUSION!!:lol_hitti

P.S. My SIL received Stadol during her first labor and touted its greatness.

Um, yeah, whatever...

P.S. I'd have to look at my medical records (those of my daughter, I guess) to see the APGAR scores...

It sounds horrible. So glad I'm past all that, age-wise.

Specializes in Case Management.

Then why use stadol at all? I am not an OB nurse but have had 4 babies myself, no stadol. My daughter had stadol during her delivery 1 yr ago (total nightmare from start to finish) but the stadol made her very loopy. She did not like it at all, she cried and then laughed in the same sentence. She made no sense. I requested the nurses not use it again as it did not help her rest at all and I think she hallucinated. Baby did fine, though.

I was given Stadol because they didn't want to give me an epidural yet. It was early in labor(about 5 hours before I had my son) so my son had no bad effects from it but still, never again. My husband said I was cussing like a sailor and I know I had to have been cussing really bad for him to say that since I have never watched my mouth around him. All I remember is thrashing around screaming in pain because it did nothing for the pain. They later told me it wouldn't lessen the pain it was just supossed to make not care that I was in pain. I still cared that I was in pain I just didn't care what I said about it.

I don't remember much while I was on it. I do remember kind of 'coming to' while they were giving me my epidural, I was already draped over the nurse and I was still really out of it. I remember the nurse telling me if I had a contraction they would stop and let it pass. Well I got hit with a monster contraction and the bp cuff inflated at that exact moment which only got me more upset and they wouldn't stop(husband informed me later that they were inserting it when the contrax hit and they couldn't stop.) I remember wanting to bite the nurse for 'lying' to me. Luckily, I had come to enough to realize that would be a really stupid thing to do and it wasn't the nurses fault that all this was happening and all that biting her would accomplish would make her mad at me, hurt her and make the rest of the nurses mad at me as well. I also realized she had not lied to me(notice the quotes around 'lying'), and I only had felt that way at that exact moment in a drug induced haze.

I decided instead to just cry on her shoulder because it hurt so bad. I still don't know why the bp cuff inflating set me off or why I had such an animalistic reaction to thinking that the nurse had 'lied' to me(which as I said before she hadn't.) I also (still) worry(4 years later) what would have happened had I not 'come to' somewhat while they were doing the epidural, would I have actually bit the nurse for what I percieved, at that moment, as an injustice in my hazy drugged up mind. The feeling that came over me was scary, thinking about it still scares me 4 years later, I hope I never get that feeling ever again.

I felt so out of control until it wore off and I really didn't like that feeling. I remember telling my doctor before I started pushing that I never ever wanted Stadol again in my life.

Even admitting how I acted and what I felt on Stadol is embarassing to me, and I worry that people might think of less of me for even saying how I felt. I think they(the doctors) need to tell you ahead of time that it isn't going to make your pain go away. Had I known what it would have actually done I wouldn't have let them give it to me. Like I said the feeling that came over me was frightening, and so not me. It makes me wonder if it puts the L&D nurses at risk of getting injured. I mean what if the next person this happens to actually does bite someone and even worse what if they have AIDS or some other infection that can be transmitted via a bite, not to mention the human mouth has a ton of nasty bacteria to begin with. The only other person who knows how I felt is my now ex-husband(and I only told him about it over a year later) because I've always been too ashamed and embarassed to admit it to anyone else. Please don't think less of me, as I said I don't know why i reacted the way I did, it is totally out of character for me.

Taryn

even admitting how i acted and what i felt on stadol is embarassing to me, and i worry that people might think of less of me for even saying how i felt. ... the only other person who knows how i felt is my now ex-husband(and i only told him about it over a year later) because i've always been too ashamed and embarassed to admit it to anyone else. please don't think less of me, as i said i don't know why i reacted the way i did, it is totally out of character for me.

taryn

oh, sweetie. never you mind that. i've always said (stadol or not) that no one should ever hold a woman responsible for anything she does or says while in labor.

i've seen straight-laced, proper ladies cuss. one even threatened to 'string the anesthesiologist up by his b@!!$' (he was caught in the or and couldn't get there to give her an epidural). :rotfl: her husband was shocked, to say the least. :eek:

don't waste any more time being ashamed about it. anyone who doesn't understand doesn't matter a hill of beans!

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