Safest Narcotic Pain Med

[MNicole]

Dr. Hale,

I am scheduled for surgery next month using general anesthesia. I'm not yet sure what my doctor will be prescribing for pain relief afterwards, but which narcotic pain med would you say transfers the least and is the safest as far as the data is concerned?

I've read a lot of previous responses so I know demerol for general anesthesia is not recommended and to wait 4 hours or so after "typical" meds. I have also read the recommendations for pain meds but I couldn't decipher what you thought was the SAFEST and BEST choice for baby out of all of the narcotic drug options, both IV in the hospital after surgery and at home via the oral route.

At the time of my surgery, my baby will be 8 1/2 months.

Thank you!

[admin]

MNicole:

The general rule about anesthesia is that as soon as your are alert and awake you can breastfeed. At 8 months, your infant is quite capable of handling the miniscule levels of these drugs in milk.

True, avoid Demerol (meperidine, pethidine) as it tends to hang around for days.

Morphine, hydrocodone, fentanyl are all suitable. But it you feel really sedated, avoid breastfeeding until awake and comfortable.


Tom Hale Ph.d.

[MNicole]

Dr. Hale,

I spoke to my doctor and he advised that he generally prescribes Percocet to be taken after surgery, which may be needed for up to 5 days.

All things considered (i.e. half life, studies on side effects in baby, amount transferred into milk, the higher strength of oxycodone vs. hydrocodone), is there one you feel would be a better option for my baby? I'm okay with either, I just want the safest and least transferred option.

Thanks again,
MNicole

[admin]

MNicole:

If newborn infant, be careful but hydrocodone 5 mg 4 times daily is probably OK. Percocet is a bit stronger, just observe for sedation.

If older infant > 6 months, then Percocet is probably OK. Just watch for sedation.

Regardless of age, Observe for sedation and poor breathing.
Also, ONLY take meds if you are in pain and really need them. Do not overdose. Do not take them if you are not in pain.

Tom Hale Ph.d.