Effects of naloxone on the breathing pattern of a newborn exposed to maternal opiates

Acta Paediatr. 2012 Jul;101(7):e309-12. doi: 10.1111/j.1651-2227.2012.02649.x. Epub 2012 Mar 27.

Abstract

Aim: To give new insights into how an infant responded to naloxone, given after acquiring a maternal opiate by recording the breathing pattern directly after birth.

Method: A respiratory recording is presented of an infant during resuscitation in the delivery room after receiving naloxone for respiratory depression, resulting from maternal remifentanyl use.

Results: The infant was born apneic and bradycardic. Normal resuscitation manoeuvres had no effect on the respiratory drive. Directly after administration of naloxone, a tachypneic breathing pattern with sporadic expiratory breaking manoeuvres was observed.

Conclusion: The immediate tachypnoea is most likely a direct effect of the naloxone causing an immediate 'rebound response' after the release of the opiate-induced inhibition of the respiratory drive.

Publication types

  • Case Reports

MeSH terms

  • Analgesics, Opioid / adverse effects*
  • Anesthetics, Intravenous / adverse effects*
  • Apnea / chemically induced
  • Apnea / drug therapy*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / chemically induced
  • Infant, Premature, Diseases / drug therapy*
  • Naloxone / pharmacology
  • Naloxone / therapeutic use*
  • Narcotic Antagonists / pharmacology
  • Narcotic Antagonists / therapeutic use*
  • Piperidines / adverse effects*
  • Pregnancy
  • Remifentanil
  • Respiratory Rate / drug effects

Substances

  • Analgesics, Opioid
  • Anesthetics, Intravenous
  • Narcotic Antagonists
  • Piperidines
  • Naloxone
  • Remifentanil