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According to Tom Hale's Medications and Mothers Milk (the guru)
tramadol has no pediatric concerns via breast milk, observe for sedation.
It isn't contraindicated. We use it occasionally in oral form when a mum
is allergic to codeine post LSCS. He doesn't give a particularly good rap
to pethidine - sedation, poor suckling reflex, neurobehavioural delay. It
may be something to consider seeing you have pharmacy support.
At the moment we use either pethidine topups of the epidural or
pethidine or morphine PCA's post LSCS, combined with REGULAR paracetamol
and voltaren round the clock. A few are starting to have either epidural
or spinal morphine in theatre which lasts 24 hours, and the women seem
really comfortable (again with regular panadol and voltaren). Morphine
doesn't seem to cause as many problems with the babies, probably because
of it's poor oral bioavailability. Hope this helps
LOUISE
-------Original Message-------
Date: Sunday, 06
October 2002 09:35:27 PM
Subject: RE:
[ozmidwifery] Tramadol
Dear Vance and Edwina,
I do not know about Tramadol in
labour but I do know that it is
contraindicaed if you are breast
feeding.
Love Lina
>From: "Vance & Edwina" <[EMAIL PROTECTED]>
>Reply-To:
[EMAIL PROTECTED]
>To:
<[EMAIL PROTECTED]>
>Subject:
RE: [ozmidwifery] Tramadol
>Date: Sat, 5 Oct 2002 19:51:51
+0930
>
>Hi Lisa,
>
>Did you ever find out more
about Tramadol - I would be interested to
>hear the
outcome.
>
>Cheers, Edwina (midwife & mother,
SA)
>
>-----Original Message-----
>From: [EMAIL PROTECTED]
>[mailto:[EMAIL PROTECTED]]
On Behalf Of Lisa
>Sent: Thursday, 12 September 2002 12:06
PM
>To: [EMAIL PROTECTED]
>Subject:
[ozmidwifery] Tramadol
>
>Hi
>The anaesthetic dept. at
the hospital where I work has asked the
>pharmacy to look at
removing pethidine from the formulary for both
>general and
maternity clients (mainly because of adverse side-effects).
>They
suggest that tramadol is a safer alternative and that a "number
of
>published studies" have shown that;
>* it is safe and
effective in labour and birth
>* it doesnt cause respiratory
depression in mother or baby
>* it has no adverse effect on:
>
- length of labour
> - incidence of instrumental birth
> -
neonatal outcome
>
>I have not read these studies. I am
interested in hearing a discussion
>around the use of this drug and
where other hospitals around the country
>are at in terms of using
both pethidine or tramadol in
labour.
>
>Lisa
>
>
>
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