Re: preemie-l Meds/Pavulon

Rosseter Family (rosseter@execpc.com)
Sun, 2 Jun 1996 17:43:46 -0500 (CDT) 

Dear Helen,

Thank you for your response.

Yes, I've heard that procedures were often done to babies while on 
Pavulon but no pain meds.  Your examples just about break my heart.

Even though NICU's have obviously come a long way in regard to pain meds, 
it can still be a battle of wills for parents to keep their babies 
comfortable.  I had to be very assertive to keep my boys on appropriate 
doses of pain medication, and even so, felt that they deserved more!

When my older son had his ileostomy done, the peritonitis and the surgery 
itself caused him so much pain he literally writhed in his isolette.  I 
had to prompt the nurses to contact the doctors in order to up his 
morphine dose and to keep it going.  The docs had their own reasons for 
cutting back on the dose, because they wanted to get his gut moving 
again, but it was very hard during that transition time when Cailean was 
still in critical condition and in a lot of pain yet the docs wanted to 
be sure his bowel was going to function.  

Devon was the same; the docs wanted find out if he had any breathing 
ability and so cut back on Pavulon and the narcotic drip - meanwhile, my 
little guy was wound up tighter than a drum and was always noted to be 
extremely irritable with handling (i.e., facial grimacing, rapidly falling 
sats, etc.) because of the pain.  So, back he'd go on the pain meds until 
he'd come a little further out of his critical state.  It was my biggest 
concern while he was on Pavulon; that he might be aware that he 
absolutely could not move and yet feel everything they were doing.  It 
about gave me nightmares.  I was assured that the pain meds would keep 
things fuzzy for him, but of course as a parent I still wonder about 
those critical times for both my boys.

Thanks again for your post.

Maureen
Mom to two cutie pie 29-weekers, Cailean (9-19-93) and Devon (11-18-95)


 On Sun, 2 Jun 1996 Helen1144@aol.com wrote:
>  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.  
  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.