NALOXONE REVERSAL OF MILD NEUROBEHAVIORAL DEPRESSION IN NORMAL NEWBORN-INFANTS AFTER ROUTINE OBSTETRIC ANALGESIA

To investigate the presence of subtle narcotic depression following maternal narcotic analgesia, the effects of naloxone vs. placebo were evaluated in a double-blind parallel group study in 43 normal term newborn infants whose mothers had received routine narcotic analgesia within 6 h prior to delivery. Infants were given either an i.m. injection of 20 .mu.g/kg naloxone or 0.20 ml/kg placebo after determination of the 1-min Apgar score, and the following measurements were compared: Apgar scores at 1 and 5 min, capillary blood gas values at 1, 60, 120 and 240 min, and neurobehavioral assessments at 1, 4 and 24 h. No adverse effects from naloxone were observed. Neither Apgar scores nor capillary blood gas determinations differed significantly between the 2 groups. Response to sound was significantly higher in the naloxone group at 24 h. The alertness score was significantly higher for the naloxone group at 1 and 4 h, the general assessment score for the naloxone groups was significantly higher at 4 and 24 h. Average scores of naloxone and placebo groups were also different at 4 and 24 h of age. Maternal narcotic analgesia may produce subtle changes in alterness and general behavior not reflected by Apgar scores or respiratory status, potentially reversible by administration of naloxone shortly following delivery.