Maternal kinetics of morphine during labour

Maternal kinetics of morphine during labour Introduction Morphine has been used for relief of labour pain since the early twentieth century [32]. After World War II the synthetic opioid meperidine, which was believed to cause less neonatal depression than morphine [16] came into use and morphine fell into disrepute as an obstetric analgesic. While the kinetics of morphine in human pregnancy have apparently never been studied, several investigations have been performed on the disposition of meperidine [15, 26, 31] and other new obstetric analgesics such as meptazinol [11] in the pregnant woman and in the neonate. It has been demonstrated that meperidine is slowly eliminated from the neonate [5, 7, 15] and the presence of the drug for several days in the neonatal urine indicates a potential for pharmacological effects during that period [15]. This drawback of meperidine as an obstetric analgesic agent was the basis of our renewed interest in morphine as a reliever of labour pain. Furthermore, in investigations on systemic analgesia during labour, morphine remains the standard with which other analgesics are compared [6]. Morphine is primarily eliminated by conjugation in the liver. Morphine-3-glucuronide (M3G), its major metabolite, lacks an analgesic effect [25] and is highly water soluble and excreted via http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Perinatal Medicine de Gruyter

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Publisher
de Gruyter
Copyright
Copyright © 2009 Walter de Gruyter
ISSN
0300-5577
eISSN
1619-3997
DOI
10.1515/jpme.1990.18.6.479
Publisher site
See Article on Publisher Site

Abstract

Introduction Morphine has been used for relief of labour pain since the early twentieth century [32]. After World War II the synthetic opioid meperidine, which was believed to cause less neonatal depression than morphine [16] came into use and morphine fell into disrepute as an obstetric analgesic. While the kinetics of morphine in human pregnancy have apparently never been studied, several investigations have been performed on the disposition of meperidine [15, 26, 31] and other new obstetric analgesics such as meptazinol [11] in the pregnant woman and in the neonate. It has been demonstrated that meperidine is slowly eliminated from the neonate [5, 7, 15] and the presence of the drug for several days in the neonatal urine indicates a potential for pharmacological effects during that period [15]. This drawback of meperidine as an obstetric analgesic agent was the basis of our renewed interest in morphine as a reliever of labour pain. Furthermore, in investigations on systemic analgesia during labour, morphine remains the standard with which other analgesics are compared [6]. Morphine is primarily eliminated by conjugation in the liver. Morphine-3-glucuronide (M3G), its major metabolite, lacks an analgesic effect [25] and is highly water soluble and excreted via

Journal

Journal of Perinatal Medicinede Gruyter

Published: Jan 1, 1990

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