Document Detail

Effect of epidural fentanyl on neonatal respiration.
MedLine Citation:
PMID:  9667297     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The addition of opioids to epidural infusions for laboring mothers may reintroduce the problem of neonatal depression seen with systemic opioids. The authors studied neonatal respiration and neurobehavior in newborns of mothers randomized to receive epidural analgesia with or without fentanyl. METHODS: One hundred thirty-eight women in labor received loading doses of plain bupivacaine. When pain-free, they received an infusion of either 0.125% bupivacaine alone or 0.0625% bupivacaine with 2.5 microg/ml fentanyl. After delivery, transcutaneous oxygen tension and carbon dioxide tension were recorded in the newborns every 10 s until 90 min after delivery using a transcutaneous oxygen-carbon dioxide monitor. Umbilical venous and arterial acid-base status, Apgar scores, and Neurologic and Adaptive Capacity Scores 2 h and 24 h after delivery were measured. The umbilical venous plasma fentanyl concentration was correlated with indices of neonatal respiration and welfare in the fentanyl group. RESULTS: One hundred fourteen newborns delivered vaginally were studied. In the fentanyl group, the mean (range) maternal dose of fentanyl was 184 microg (range, 53-400), and the umbilical venous fentanyl concentration was 0.077 ng/ml (range, <0.021 to 0.244). There were no significant differences between the groups for any indices of neonatal respiration or neonatal welfare, and the plasma fentanyl concentration did not correlate with any of these indices. CONCLUSIONS: The results suggest that fentanyl added to epidural bupivacaine infusions during labor does not depress neonatal respiration or adversely affect neurobehavioral scores and other indices of neonatal welfare.
J Porter; E Bonello; F Reynolds
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  89     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-08-05     Completed Date:  1998-08-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  79-85     Citation Subset:  AIM; IM    
Anaesthetic Department, St. Thomas' Hospital, London, United Kingdom.
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MeSH Terms
Analgesics, Opioid / administration & dosage*,  adverse effects*
Fentanyl / administration & dosage*,  adverse effects*
Infant, Newborn / physiology*
Injections, Spinal
Labor, Obstetric*
Maternal-Fetal Exchange
Pain / prevention & control*
Respiration Disorders / chemically induced*
Reg. No./Substance:
0/Analgesics, Opioid; 437-38-7/Fentanyl
Erratum In:
Anesthesiology 1998 Dec;89(6):1615

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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