Vol. 3 No 02 (2019)
Original Article

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

Most. Eleza Khanom
Jr. Consultant (Gynae & Obs.), UHC, Tanore, Rajshahi. Email-smcdmc@gmail.com
Md. Abdul Hye
Asst. Professor (Pediatrics), Naogaon Medical College, Naogaon
Rahat Bin Habib
Asst. Professor (Pediatrics), Saheed Sayed Nazrul Islam Medical College, Kishoreganj
Rummana Sultana
Consultant (Gynae & Obstetrics), Medical Centre. National Parliament Secretariat
Mohammad Abdul Wahab
Asst. Professor (Anaethesiology), Saheed Sayed Nazrul Islam Medical Collage, Kishoreganj
Taslim Ara Nila
Junior Consultant (Gynae & Obs.), Saheed Sayed Nazrul Islam Medical Collage, Kishoreganj
Md. Kamrul Ahsan Khan
Assistant Professor (Neonatology), Sheikh Sayera Khatun Medical Collage, Gopalganj

Publiée 2021-09-21

Mots-clés

  • Nalbuphine HCl,
  • pregnancy,
  • antepartum hemorrhage,
  • neonate,
  • caesarean section

Comment citer

1.
Neurological Fetal Damage after Administration of Nalbuphine Hydrochloride in Antenatal Period: A case report. Planet (Barisal) [Internet]. 21 sept. 2021 [cité 24 nov. 2024];3(02):4. Disponible sur: https://bdjournals.org/index.php/planet/article/view/38

Résumé

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.

Références

  1. Podlas J, Breland BB. Patients controlled analgesia with Nalbuphine during labor. Obstet Gynacol. 1987; 70:202-4.
  2. Errick JK, Hee RC. Nalbuphine: A preliminary review of its pharmacological properties and therapeutic efficacy. Drugs. 1983; 226:191-211.
  3. Littleford J, Effects on the fetus and newborn of maternal analgesia and anesthesia: A review. Can J Anesth. 2004; 51(6):586-609.
  4. Schmitz R. Friedrich Wilhelm Sertürner and the discovery of morphine. Pharm Hist. 1985; 27(2):61-74.
  5. Amin SM, Amr YM, Fathy SM, Alzeftawy AE. Maternal and Neonatal effects of Nalbuphine given immediately before induction of general anesthesia for
  6. elective caesarean section. Saudi Journal of Anesthesia. 2011;5(4):371-75.
  7. Amin OAI, Ibrahem MA, Salem DAE. Nalbuphine versus midazolam as an adjuvant to intrathecal Bupivacaine for postoperative analgesia in patients undergoing caesarean section. J Pain Res. 2020; 13:1369-76.
  8. Nicolle E. Devillier P, Delanoy B, Durand C, Bessard G. Therapeutic monitoring of Nalbuphine: Transplacental transfer and estimated pharmacokinetics in the
  9. neonate. Eur. J. Clinical pharmacology. 1996; 49:485-89.
  10. Dadabhoy ZP, Tapia DP, Zsigmond EK. Transplacental transfer of Nalbuphine in patients undergoing caesarean section. Anesth. Analg. 1985; 64: 205-10.