Document Detail


Epidural analgesia with ropivacaine and sufentanil is associated with transient fetal heart rate changes.
MedLine Citation:
PMID:  20395896     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Fetal heart rate (FHR) changes have been reported after regional labor analgesia. In this prospective single-blinded study, we aimed to assess whether epidural analgesia with ropivacaine and sufentanil is associated with significant changes in fetal heart rate.
METHODS: Fetal heart rate traces from 120 women in active labor requesting epidural analgesia were recorded and analyzed by two reviewers 90 minutes before and after epidural analgesia for baseline fetal heart rate, accelerations, decelerations and long-term variability.
RESULTS: A significantly decreased number of fetal heart rate accelerations (ANOVA P=0.0001) and a higher percentage of segments with decelerations (P<0.05) were observed in the three segments after analgesia as compared to the three preceding segments. The minimum number of accelerations occurred during the 30 minutes immediately after analgesia was initiated. The reviewers were concordant in finding a significant change from the 60 minutes before to the 60 minutes after analgesia, a period in which there
CONCLUSION: Epidural analgesia with ropivacaine and sufentanil is associated with fetal heart rate changes. These modifications are transient and should be considered when evaluating fetal heart rate monitoring during labor to prevent inappropriate obstetric management decisions to proceed with operative labor.
Authors:
A Wolfler; I Salvo; G Sortino; F Bonati; F Izzo
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Minerva anestesiologica     Volume:  76     ISSN:  1827-1596     ISO Abbreviation:  Minerva Anestesiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-16     Completed Date:  2010-07-09     Revised Date:  2010-12-08    
Medline Journal Info:
Nlm Unique ID:  0375272     Medline TA:  Minerva Anestesiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  340-5     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Intensive Care, Women and Children's Hospital Vittore Buzzi, ICP, Milan, Italy. andrea.wolfler@icp.mi.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Amides / adverse effects*
Analgesics, Opioid / administration & dosage*
Anesthesia, Epidural / adverse effects*
Anesthesia, Obstetrical / adverse effects*
Anesthetics, Local / adverse effects*
Female
Heart Rate, Fetal / drug effects*
Humans
Labor, Obstetric / drug effects
Pregnancy
Prospective Studies
Single-Blind Method
Sufentanil / adverse effects*
Young Adult
Chemical
Reg. No./Substance:
0/Amides; 0/Analgesics, Opioid; 0/Anesthetics, Local; 56030-54-7/Sufentanil; 84057-95-4/ropivacaine
Comments/Corrections
Comment In:
Minerva Anestesiol. 2010 May;76(5):314-5   [PMID:  20395892 ]
Minerva Anestesiol. 2010 Nov;76(11):965; author reply 966   [PMID:  20592680 ]

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


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