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Combined spinal epidural analgesia for labor using sufentanil epidurally versus intrathecally: a retrospective study on the influence on fetal heart trace.
MedLine Citation:
PMID:  24922321     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: We retrospectively compared a protocol using sufentanil and ropivacaine intrathecally with a protocol in which only ropivacaine was administered intrathecally and sufentanil was used epidurally to evaluate whether banning sufentanil from the intrathecal space results in a decreased incidence of adverse fetal heart rate changes. Methods: Some 520 cardiotocographic tracings were examined for changes in fetal heart rate and uterine activity following two different protocols of combined spinal epidural analgesia. Charts were consulted for neonatal and labor outcome. Results: When sufentanil was used epidurally instead of intrathecally, the incidence of adverse changes in fetal heart trace was less, demonstrated by a higher percentage of normal reassuring tracings (74.5% vs. 60.4% when sufentanil was used intrathecally; P=0.007), less tracings showing bradycardia (7.5% vs. 14.1%; P=0.035), and more tracings displaying 3 or more accelerations in fetal heart rate in 45 min (93.5% vs. 83.9%; P=0.003) together with less episodes of tachycardia (3.5% vs. 11.4%; P=0.005). There were no differences in labor and neonatal outcome. Conclusions: Based on fetal heart tracing, it seems favorable to ban sufentanil from the intrathecal compartment.
Authors:
Nele Everaert; Marc Coppens; Peter Vlerick; Geert Braems; Patrick Wouters; Stefan De Hert
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-12
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  -     ISSN:  1619-3997     ISO Abbreviation:  J Perinat Med     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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