Intravenous meperidine during labor: a randomized comparison between nursing- and patient-controlled administration

Article Abstract:

Meperidine is a narcotic pain reliever that can control pain during labor. The pain of labor is usually difficult to control because the pain is characteristically short, cyclic and more intense than pain experienced after surgery. If the drug is given too infrequently or if there is a delay between doses, the pain may not be adequately controlled. Since all narcotics doses are cumulative and pass through the placenta from the mother to the fetus, an overload of drugs could depress the nervous system functioning of the fetus before and after delivery. In an effort to reduce the total amount of the drug used during labor, a scheme was developed that permits patients to self-administer the pain medication using a specially designed drug delivery system. The efficacy of self-administration was compared with nurse-administered medication in 64 healthy women in active labor. Meperidine 10 mg could be self-administered as often as every 20 minutes, or nurse-administered 25-50 mg every three hours as needed. Although the pain relief was similar during both administrations, the concentration of the drug in the blood of the mother and infant was higher when the drug was administered by the patient. A drug that cancels the effects of meperidine (naloxone) had to be used more often in infants born to mothers using self-administered medication (5 out of 31, or 16 percent) than nurse-administered (3 out of 33, 10 percent) medication. The patient-controlled administration of meperidine is not favored over nurse administration at this time. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug delivery systems, Dosage and administration, Self medication, Meperidine

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Fentanyl citrate analgesia during labor

Article Abstract:

Fentanyl citrate is a strong short-acting narcotic used for the control of pain in nonpregnant patients. It has fewer side effects than morphine or meperidine hydrochloride, and has a less sedative effect. The safety of fentanyl for use in pregnant patients has not been determined. Standard doses of fentanyl were given to 137 women during active labor, with hourly increases as needed. Mild sedation and pain relief were apparent. Brief decreases in fetal heart rates were noted for short periods of time, but no dangerous patterns were noted. After delivery, fetuses were examined and evaluated for complications; no differences were found at 2 and 24 hours. The use of recommended doses of fentanyl citrate as an effective and safe treatment for pain during labor shows promise, although further studies confirming safety should follow.

Care and treatment, Complications and side effects, Pain management, Infants (Newborn), Newborn infants, Narcotics

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Use of micro-dose human chorionic gonadotropin (hCG) after clomiphene citrate (CC) to complete folliculogenesis in previous CC-resistant anovulation

Article Abstract:

The study compared the effectiveness of low-dose human chorionic gonadotropin (hCG) in the late follicular phase to induced ovulation and its endocrine response in patients who had previously failed to ovulate on clomiphene citrate (CC) alone. It is concluded that the use of micro-dose hCG after CC in the late follicular phase results in continued follicle growth, increased E2 levels, ovulation, and pregnancies.

United States, Science & research, Research, Chorionic gonadotropin, Chorionic gonadotropins, Ovulation, Anovulation

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