Re: preemie-l Meds/Pavulon
Helen1144@aol.com
Sun, 2 Jun 1996 17:48:38 -0400
Dear Maureen,
I don't know of any long term problems with Pavulon. However, I do know of
problems with using Pavulon to paralyze babies for painful procedures.
Preemies used to be paralyzed but not anesthetized or given any type of pain
relief for various types of surgery -- ductus ligation, shunt installation,
NEC surgery, etc. Many babies died or suffered IVH or other physical
problems resulting from the stress caused by the pain. Pavulon was used as a
kind of chemical straight jacket and although it did not directly produce the
damage, it allowed MDs to inflict unrelieved medical or surgical pain that
did cause damage. Babies were widely thought (in the 1980s) to be too
immature to feel pain, but we now know that this isn't the case. By the way,
it was a mother of a preemie (Jill Lawson of Silver Spring, Maryland) who
changed all this by going to The Washington Post in 1986 to talk about her
son's PDA ligation using Pavulon but no anesthesia. (Her child subseqeuntly
died.) The revelation that babies were being poerated on without anesthesia
caused great embarrassment in the medical community and quickly led to the
publication of research showing that infants (including preemies) felt pain
and could be damaged by it. Since then there has been much more attention
given to pain control for infants and children. Even so, preemies are still
greatly undermedicated for pain compared to older patients. One of many
reasons for this may be that the use of Pavulon allows caregivers to overlook
the pain the babies are feeling but can't express. Therefore, it was a good
thing that Devon was given narcotics with the Pavulon (my son and many other
babies weren't). I share your concern about preemies' abilities to process
so many drugs, but I worry even more about their abilities to cope with
unrelieved pain.
Best regards,
Helen Harrison