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Propofol with possible versed and seconal?

post #1 of 6
Thread Starter 
This is what is possibly being given to me for my D&C next week-I have some retained placenta from my dd2s birth in June.

I spoke with the anasthesiologist dept today and they said I would have to pump and dump for a minimum of 24 hrs. Does this make sense? I don't have a recent Hale's-but I looked it up on mother to mother and Propofol was L2 and versed and seconal were L3.

What do you think? I am going to call my LLL to see if she has more info-but I thought I would ask here first?
post #2 of 6
All 3 of those are short half-life drugs, meaning they are out of your system fairly quickly. I would guess you will not need the seconal if they give propofol and versed, though. Should be safe to nurse the baby as soon as you are awake enough to do so. Think of anesthesia drugs this way: if they are out of your system enough that you are awake and functioning, there is even less available in breastmilk. You might still need to a leave some pumped milk for baby if the time frame will be long enough that she'll need to eat while you are under and in recovery, but you should be fine to nurse the baby as soon as you are awake.

I had a hand surgery done with propofol and versed when ds2 was 8 mos or so and nursed him as soon as I was home with no ill effects. I had not planned on having anesthesia as they were supposed to just use a local block, and had to call the LLL hotline for info after as of course no one in the hospital knew anything and I didn't know any better yet:. Since then, I've learned a lot more about common drugs and these ones wouldn't worry me at all. On the plus side, the propofol had no anesthesia side effects for me - I wake from general anesthesia with horrible nausea and feel off kilter for days, while I woke from the propofol (which is IV sedation, not a true general anesthesia) feeling great, like I'd just had a good nap. I hope you'll have the same experience! Good luck.
post #3 of 6
Thread Starter 
Thanks, Dr. Jen That is what I was thinking.

Now-I just have to figure out an alternative way to feed her-she will.not.take a bottle. I am not sure what to do-she might take some by syringe? I just hope she will take a little bit somehow-I hope it won't take that long-or she is going to be p.o.'d if she has to go too long without eating
post #4 of 6
Quote:
Originally Posted by pumpkinseed View Post
Thanks, Dr. Jen That is what I was thinking.

Now-I just have to figure out an alternative way to feed her-she will.not.take a bottle. I am not sure what to do-she might take some by syringe? I just hope she will take a little bit somehow-I hope it won't take that long-or she is going to be p.o.'d if she has to go too long without eating
cup
syringe
stand on one leg, bounce baby on lap
face baby in
face baby out
drip into cup
drip from cup into mouth
repeat.

by then, mama will probably be ready to nurse, right?

We'll be thinking of you p'seed.
post #5 of 6
I'm also an LC, but when it comes to these questions I go to Hale's website. Info from the site is below. Here is the link to the page:
http://neonatal.ama.ttuhsc.edu/cgi-b...cus/discus.cgi
You can use the guest entrance under medical professionals and search for any of the other drugs that may be involved.

However, the rule of thumb is that if you can hold the baby w/o dropping, then the drugs are out of your system and should not leave significant amounts in the breast milk.

Have a good friend who is a hospital based LC and a LLL. She deals with this stuff all the time. She has found that the anesthesiologists tell moms to pump and dump because they think they are being cautious. They have little knowledge of the pharmacokinetics and breastfeeding, nor the risk of mastitis if mom doesn't nurse.


http://66.230.33.248/discus/icons/cs...arrow_down.gif Suec posted on Tuesday, June 10, 2008 - 11:34 am http://66.230.33.248/discus/icons/csc/1px.gifhttp://66.230.33.248/discus/icons/cs..._icon_edit.gif http://66.230.33.248/discus/icons/csc/1px.gifhttp://66.230.33.248/discus/icons/cs...con_delete.gif http://66.230.33.248/discus/icons/csc/1px.gifhttp://66.230.33.248/discus/icons/cs...icon_print.gif I am the director of nursing at an endoscopy center. Our patients receive either versed/fentanyl or propofol for sedation and rarely receive other medications while here. My staff have received very different guidelines from OBGYNs, nurse consultant, anesthesia, and the GI MDs regarding what to tell patients about resumption of breast feeding. What are your recommendations on when they can resume breastfeeding (and do recommendations vary depending on age of child and the sedation chosen (versed/fentanyl or propofol). THANKS http://66.230.33.248/discus/icons/cs...ssage_body.gif http://66.230.33.248/discus/icons/csc/1px.gif http://66.230.33.248/discus/icons/cs...arrow_down.gif Tom posted on Tuesday, June 10, 2008 - 01:14 pm http://66.230.33.248/discus/icons/csc/1px.gifhttp://66.230.33.248/discus/icons/cs..._icon_edit.gif http://66.230.33.248/discus/icons/csc/1px.gifhttp://66.230.33.248/discus/icons/cs...con_delete.gif http://66.230.33.248/discus/icons/csc/1px.gifhttp://66.230.33.248/discus/icons/cs...icon_print.gif Sue:

Basically, as soon as the mother is awake, alert and not groggy, its probably OK to return to breastfeeding. At this point virtually all the drug is in the peripheral compartments and not in milk. Versed is undetectable in milk after 2 hours. Fentanyl about the same. Levels of propofol at 4 hours are quite low.

Check the ABM protocols at this link:
http://www.bfmed.org/ace-images/Protocol_15_06.pdf


Tom Hale Ph.D.HTH
mothercat
post #6 of 6
Thread Starter 
Thank you, guys! That Hale's forum is great, Mothercat-thanks for the link!

I had my pre-op appt today and my dr confirmed what Hale's said-she said not to worry about it-and nurse dd whenever I was able to when I returned home. I just hate getting conflicting advice!

She did say that depending on what she finds in there-I may have to go on a short course of estrogen to heal the uterus. I really don't want to do this because I heard it can really damage milk supply. She agrees with this but said it might be necessary if she needs to do any cauterization Is there anything I could do if I had to go on estrogen?? She didn't know the answer to this.

Still no bottle taking over here...
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