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Re: Born In the USA From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com) Fri Nov 3 11:03:28 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr Eberhard W Lisse: "Re: CNMs and Water Births" Previous message: ainsron@msn.com: "Re: VIN and coding" In reply to: Cheri Van Hoover: "Re: Born In the USA" Next in thread: Larry Glazerman: "Re: Born In the USA" I do the same, but at 20 minutes. Has to do with the pharmokinetics of morphine metabolism. Give the second dose too late and they stay narcotized too long. -- Richard Chudacoff, MD Chudacoff Obstetrics & Gynecology, PLLC 15200 Southwest Freeway, #270 Sugar Land, TX 77478 Tel: 281-277-3900 Fax: 281-277-3901 rchudacoff@mylinuxisp.com Richard.Chudacoff@obgyn.net ********************************************************************** Neither the confidentiality nor the integrity of this message can be guaranteed following transmission on the Internet. ********************************************************************** -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Cheri Van Hoover Sent: Thursday, November 02, 2000 11:50 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Born In the USA Joanne Bulley wrote: > Yup. Gotta use the big doses - if you're gonna sleep them - you want to > really sleep them! 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 Next message: Dr Eberhard W Lisse: "Re: CNMs and Water Births" Previous message: ainsron@msn.com: "Re: VIN and coding" In reply to: Cheri Van Hoover: "Re: Born In the USA" Next in thread: Larry Glazerman: "Re: Born In the USA"

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