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Re: Born In the USAFrom: Cheri Van Hoover (cherivh@home.com)Thu Nov 2 22:50:07 2000
Joanne Bulley wrote:
> Yup. Gotta use the big doses - if you're gonna sleep them - you want to The first MD I worked with out of midwifery school used a protocol he had learned at Beth Israel Hospital. Or at least that's where he said he learned it. 15 mg. morphine IM. If not asleep in one hour, repeat with 10 mg. morphine IM. He avoided barbiturates and/or phenergan because of the long half-lives and because they could not be reversed with Narcan if the patient labored and progressed rapidly. I have used this regimen for about 12 years, with very good results. No respiratory depression or fetal distress, excellent relief of prodromal symptoms, and frequent progress into active labor so the woman would wake up 4-6 cm. dilated and go on to labor spontaneously and normally. I don't sleep them unless it truly is prolonged latent phase - greater than 20 hours in a primip - and it is evening or night time. The nurses at one of the hospitals I worked at referred to this as my "morphine induction" technique because of the frequency of good relaxation and subsequent progress in labor.
-- Cheri Van Hoover, CNM San Francisco, CA
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