***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Nalorphine and naloxone were compared as to their effectiveness as pethidine antagonists .  85 infants were divided into a control group containing 19 newborn babies whose mothers did not receive pethidine and the babies received no antagonist  , and three groups in which the mothers all received pethidine and the babies had either no antagonist ( 24 ) , nalorphine IV ( 16 ) , or naloxone IV ( 26 ) . All the babies were assessed by measuring their neurobehavioural states and respiratory functions . A further 12 newborn babies had  naloxone  plasma levels measured by radioimmunoassay . Although st and ard doses of nalorphine effectively antagonised the depressive effect on respiration induced by pethidine , there was a pronounced and undesirable excitatory agonist action .  Naloxone was not observed to have any agonist activity , but the recommended IV dose ( 0.01 mg/kg ) had only a slight and delayed antagonist action as measured by respiratory function tests . A more rapid and improved antagonism was noted after this dose was doubled ( 0.02 mg/kg ) . The plasma elimination-phase half-life of naloxone after intravenous cord injection was about 3 To investigate the presence of subtle narcotic depression following maternal narcotic analgesia , we have evaluated the effects of naloxone versus placebo in a double-blind parallel group study in 43 normal term newborn infants whose mothers had received routine narcotic analgesia within six hours prior to delivery . Infants were given either an intramuscular injection of 20 microgram/kg naloxone or 0.20 ml/kg placebo after determination of the one-minute Apgar score , and the following measurements were compared : Apgar scores at one and five minutes , capillary blood gas values at one , 60 , 120 , and 240 minutes , and neurobehavioral assessment s at one , 4 , and 24 hours . No adverse effects from naloxone were observed . Neither Apgar scores nor capillary blood gas determinations differed significantly between the two groups . Response to sound was significantly higher in the naloxone group at 24 hours . The alertness score was significantly higher for the naloxone group at one and four hours ; the general assessment score for the naloxone group was significantly higher at four and 24 hours . Average scores of naloxone and placebo groups were also different at four and 24 hours of age . These data demonstrate that maternal narcotic analgesia may produce subtle changes in alertness and general behavior not reflected by Apgar scores or respiratory status , potentially reversible by administration of naloxone shortly following delivery Abstract . Infants born to mothers receiving 100 mg of pethidine during labor , were r and omly given either 100 μg of naloxone ( n = 14 ) or 0.25 ml 0.9 % NaCl ( n = 13 ) one hour post partum . Infant behavior was assessed with the Brazelton Neonatal Behavioral Assessment Scale ( BNBAS ) and the Broussard Neonatal Perception Inventory ( NPI ) . No differences in cluster scores on the BNBAS were found between the two groups . Both groups improved scores over time in 4 out of 7 clusters . On the NPI , mothers assessed naloxone infants as having less optimal behavior than did the control mothers . The results of this study on the effects of naloxone on infant behavior and maternal perception of newborn behavior do not warrant administration of naloxone after maternal analgesia with pethidine in the absence of clinical evidence of respiratory depression in the newborn The effects on mature newborn have been compared at 0.5 , 4 , 8 12 24 and 48 hr after birth , of maternally administered epidural bupivacaine ( 11 babies ) or pethidine ( 18 babies ) or pethidine reversed by naloxone administered intramuscularly to the newborn ( 15 babies ) .  Bupivacaine ( mean dose 130 mg ) had less effect that pethidine ( mean dose 183.3 mg ) on alveolar carbon dioxide tension ( PACO2 ) at 0.5 hr after birth , but had a similar effect to pethidine on feeding , elicited reflexes and produced more depression of muscle tone up to 48 hr . Bupivacaine had more effect on PACO2 feeding measures , elicited reflexes and muscle tone at almost all examination periods than pethidine ( mean dose 157.0 mg ) reversed by naloxone ( 200 micrograms intramuscularly ) . Except at delivery , the effects of bupivacaine or pethidine on respiration and feeding up to 48 hr after birth were similar . There were more signs of depression with both drugs than when pethidine had been reversed by naloxone Twenty neonates whose mothers had received meperidine ( 1.0 to 1.5 mg/kg ) intravenously within three hours of delivery were studied to determine the effectiveness of naloxone in reversing  neonatal respiratory depression .  The following measurements were carried out within 20 to 30 minutes after delivery : minute ventilation , end tidal CO2 , and ventilatory response to CO2 . These determinations were repeated after administration of either placebo or naloxone , 0.01 mg/kg intramuscularly . Minute ventilation and PAco were within a normal range before medication in both groups , but the slope of the CO2 response curve was decreased , indicating mild-to-moderate respiratory depression . After administration of placebo the test results did not change significantly . After administration of naloxone , VE increased significantly ( P less than 0.05 ) and the slope of the CO2 response curve doubled ( P less than 0.001 ) . Naloxone effectively reverses narcotic depression of the respiratory center in the newborn infant 
    Output:
    
Although there was evidence that naloxone increased alveolar ventilation , no data were found on the specified primary outcomes of this review : the need for assisted ventilation or admission to a neonatal unit .
CONCLUSIONS There is a need for a r and omised controlled trial to determine if naloxone confers any clinical ly important benefits on newborn infants with respiratory depression that may be due to transplacentally acquired narcotic