Neurological Fetal Damage after Administration of Nalbuphine Hydrochloride in Antenatal Period: A case report

Abstract

Introduction: Nalbuphine Hydrochloride (NB.HCL) is a synthetic agonist and antagonistopioid analgesic available for use in severe pain management and during labor & delivery. Itcan also be used as a supplement to balanced analgesic for preoperative and postoperativeanalgesia. Though it is safe & potent analgesic but sometimes it causes respiratory depressionat birth, fetal bradycardia, apnea, cyanosis, hypotonia, neurological damage and even death.NB.HCI should be used in antenatal period and during labor & delivery, only if clearly indicatedand the potential benefit outweighs the risk to the infant. Newborns should be monitored forrespiratory depression, apnea, bradycardia and arrhythmia. A case presentation is given of apersistent neurological damage of newborn appearing after NB. HCI administration in theantepartum period. Methods: This case report describes the neurological damage of fetus afterseveral administrations of NB.HCL in the antenatal period. Conclusion: As fetal bradycardiaoccurs following the use of NB.HCI in antepartum period, so when it is used to pregnant motherin antenatal period, all the measures for monitoring and resuscitation must be availableincluding attendance of pediatrician or neonatologist to reduce development of fetal neuronaldamage and subsequent morbidity.