Obstetrical medication and the newborn infant. II: The influence of meperidine (pethidine) on visual behaviour

The visual fixation of two groups of healthy newborn infants was tested at a mean age of three days. Mothers of the infants in one group received a single dose of meperidine (pethidine) during labour and delivery; those in the second group received no medication. Unlike infants of mothers who received a single dose of alphaprodine hydrochloride in a previous study, there were no differences between the groups in the present study. Moreover, longer drug-to-delivery intervals did not appear to potentiate the effects of meperidine. A single dose of meperidine appears to have few effects on neonates' sensory functioning, which is contrary to other reports.

The relationship between maternal labour analgesia and delay in the initiation of breastfeeding in healthy neonates in the early neonatal period

An Infant Breastfeeding Assessment Tool was used to assess the breastfeeding behaviour of 38 healthy, full-term newborn babies of multiparous women from birth until effective feeding was established. After data collection was completed, the babies were divided into a non-medicated group (n = 18) and an alphaprodine group (n = 20) based upon the medication profile of the mother. Inter-group differences were analysed using ANOVA and Dunnett's t-test. The dependent variables were the hours from birth to establishing effective breastfeeding and IBFAT scores at 12, 24, 36 and 48 hours after birth. The findings suggest that even small doses of the narcotic analgesic alphaprodine, when administered 1 to 3 hours prior to delivery, can delay effective feeding by several hours and in some cases, days.

Quantum chemical studies of meperidine and prodine

Extensive quantum chemical calculations have been made of the electronic distribution and conformational behavior of meperidine and desmethyl-, (+)-alpha, and (+)-beta-prodine using PCILO, a semiempirical molecular orbital method. For this series of opiates, a phenyl equatorial conformation was preferred over a phenyl axial one, with the equatorial conformer most favored in the most potent compounds. Using the low-energy equatorial conformer obtained for each compound, together with calculated net atomic charges, their observed potency variation could successfully be explained. From the results, these compounds appear to act at the morphine receptor with an identical piperidine rather than phenyl ring site.

Newborn Attention as Affected by Medication during Labor

Babies, 2- to 4-days old, whose mothers received heavy medication during labor were less attentive than those babies whose mothers received light medication.

[Preliminary clinical study on the use of dihexyverine in obstetrics]

This study attempted to evaluate the effect of dihexyverine HCl (Metaspas), an anticholinergic and direct smooth muscle relaxant (spasmolytic), in shortening the first stage of labour. One hundred and five patients constituted the series: 31 were primiparae, 27 secundiparae and 47 multiparae. The majority of these (95) received one intramuscular injection (10 mg.) of dihexyverine. Alphaprodine (Nisentil), 40 mg., was administered in all but 10 cases, since dihexyverine has no analgesic action. Seventy-five control patients were used: 25 were primiparae, 25 secundiparae and 25 multiparae. Alphaprodine alone was administered to these control patients. The length of time for dilatation from 4 cm. to 10 cm. was the selected criterion. In the control group, the average time for complete cervical dilatation was 4 hours, 10 minutes. In the group treated by dihexyverine, complete dilatation was achieved in 1 hour, 16 minutes. On the average, the first stage of labour was 2 hours and 54 minutes shorter with dihexyverine; the clinical effect begins 10-30 minutes after administration. The only side effect encountered was a skin rash in one patient.

Alpha- and beta-prodine type compounds: configurational studies

The addition of various lithium aryl compounds to 1:3-dimethyl-4-piperidone is investigated. Those stereoisomers present as the major proportion of the respective stereoisomeric mixtures are shown to have similar infra-red absorption characteristics which are different from those exhibited by those isomers formed in minor amount. The stereochemistry of addition to 6-membered alicyclic and heterocyclic ketones is discussed; on the basis of these discussions, and the rates of hydrolysis of appropriate esters, the above isomers formed in major amount are allocated the trans (Me/Ar) configuration. The analgesic activities in mice of various stereoisomeric amino-alcohols and esters are given.

Continuous nisentil and suxamethonium in anaesthesia

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