Intravenous morphine as painkiller for woman in labor and possible side effects in the newborn
If an intravenous morphine injection is given as a painkiller to a pregnant woman during childbirth, what side effects should we look out for in the newborn, and if so, what should we do for the baby?
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By asking a few people I had access to and also searching in some of my reference books like Katzung, Martindale, and finally looking at Newborn Services Drug Protocol, I think I may have reached a conclusion.
Respiratory depression is a possible side effect which could occur in neonates. The drug of choice is Naloxone, although it may not be used in the initial resuscitation. Prior to that, heart rate should be restored by adequate ventilation. Naloxone is administered with the dose of 0.1-0.2 mg/kg/dose and the preferred route of administration is I.M. injection. Because the narcotic duration of action may exceed that of Naloxone, continued monitering of respiratory function is essential, and repeated doses may be necessary.
Prophylactic Naloxone has not been shown to have any clinical benefits.
And since I asked myself in comments if there may be neonatal withdrawal syndrome, I answer that here too and the answer is no. The reason is withdrawal syndrome only presents itself if the mother has had chronic use of morphine a.k.a. addiction.
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