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Safe reduction in administration of naloxone to newborn infants: An observational study

Background: Naloxone, a specific opiate antagonist, is widely used during neonatal resuscitation to reverse possible opiate‐induced respiratory depression. Aim: To determine the frequency with which naloxone is administered when resuscitation guidelines are conscientiously followed and to document any effect on respiratory morbidity. Methods: Perinatal data including naloxone administration and respiratory morbidity were collected retrospectively, and compared with prospectively collected data following the introduction of “Good Practice” guidelines. Results: There were 500 deliveries in the retrospective arm of the study and 1000 deliveries in the prospective arm. Although a similar proportion of women received opiates in labour in the two periods of study, there was a marked reduction in the use of naloxone when the guidelines were introduced (11% of opiate‐exposed deliveries compared to 0.2%). There was no significant effect on respiratory morbidity with the change in practice.