The new article in "Anesthesiology" indicates a lower Neurologic and
Adaptive Capacity Score (NACS) at 24 hr. in one group after an epidural
delivery, but says, "Despite our findings, we do not believe that the
differences in NACS indicate neurobehavioral depression with fentanyl that
is of clinical concern... To date, no adverse long term effects have been
associated with transient drug-related neurobehavioral depression."

How do we request that the standards for longterm effects include infant
feeding outcomes?  The baby who recovers all his marbles on Day 2, but for
whom breastfeeding terminates because of problems on Day 1, has most
certainly suffered an "adverse long term effect" - one that researchers
should be expected to address in their studies.

Hmphf!
Diane Wiessinger, MS, IBCLC, LLLL  Ithaca, NY  [log in to unmask]
(Anesthesiology 83(2):300-308, 1995  Placental transfer and neonatal
effects of epidural sufentanil and fentanyl administered with bupivacaine
during labor.  Loftus, Hill, Cohen)