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Anesth Analg 1985; 64:658-666
© 1985 International Anesthesia Research Society
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The Effects of Naloxone Associated with the Intrathecal Use of Morphine in Labor

Patricia A. Dailey, MD, G. Lee Brookshire, MD, Sol M. Shnider, MD, Therese K. Abboud, MD, Dennis M. Kotelko, MD, FRCP(C), Rabiha Noueihid, MD, Jarman W. Thigpen, MD, Swee S. Khoo, MD, Julio A. Raya, MD, Stanley E. Foutz, MD, Ray V. Brizgys, MD, Uwe Goebelsmann, MD, and Man-Wai Lo, PhD

Received from the Department of Anesthesia, University of California, San Francisco, California, and the University of Southern California, Los Angeles, California; the Anesthesia and Operative Services, Letterman Army Medical Center, San Francisco, California; and the Department of Obstetrics and Gynecology, University of Southern California.

Abstract

The efficacy of naloxone in reducing the incidence of side effects after intrathecal injection of morphine and the effects of maternal naloxone administration on the condition of the newborn were evaluated in 40 patients. Patients in labor were given a 1-mg intrathecal injection of morphineand, 1 hr later, either a 0.4-mg bolus of naloxone, followed by a 0.4–0.6 mg/hr intravenous infusion of naloxone, or an intravenous bolus of saline, followed by an intravenous infusion of saline. Intrathecal morphine provided at least 50% pain relief in 78% of patients given naloxone, and in 82% given saline. Intravenous naloxone significantly decreased the incidence of pruritus during labor and delivery. There was no significant decrease in the incidence of nausea, vomiting, somnolence, dizziness, or urinary retention in patients given naloxone. Despite placental transfer of naloxone, neonatal outcome was not adversely affected. For both groups, maternal ß-endorphin levels decreased significantly with the onset of analgesia and returned to control levels at delivery. We conclude that intravenous infusion of naloxone reduced pruritus after intrathecal injection of 1 mg of morphine for labor pain without lessening analgesia or adversely affecting maternal or neonatal status.

Key Words: ANALGESICS—morphine • ANESTHESIA—obstetrics • ANESTHETIC TECHNIQUES—spinal • ANTAGONIST, NARCOTICS—naloxone






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1985 by the International Anesthesia Research Society.