Continuous Mini-Infusion of Bupivacaine in the Epidural Space During Labor. Experience from 1000 Deliveries

Hanson, A. L.; Hanson, B.

doi:10.1097/00132582-198606000-00009

Cited by 3 publications

(3 citation statements)

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“…It has been shown that the position of the patient is important for the relief of perineal pain when low concentrations of local anaesthetics are used. 17 In this study, the addition of i00 ~g of fcntanyl increased significantly the quality of analgesia, preserving the benefit of a low dose of local anaesthetm. Previously 80-100 la,g of fentanyl was demonstrated to be effective in producing good perineal analgesia in the presence of a persistant occipito-posterior position.…”

Section: Discussionmentioning

confidence: 65%

Epidural fentanyl plus bupivacaine 0.125 per cent for labour: analgesic effects

Celleno¹,

Capogna²

1988

Can J Anaesth

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Section: Discussionmentioning

confidence: 65%

Epidural fentanyl plus bupivacaine 0.125 per cent for labour: analgesic effects

Celleno¹,

Capogna²

1988

Can J Anaesth

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“…Such drugs may therefore depress newborn neurobehavioural scores [23,24]. This is not generally the case with bupivacaine [12] which, in normal doses for Caesarean section or labour, is not associated with maternal toxicity or adverse neonatal effects [25][26][27]. However, there are still concerns regarding epidurally administered opioid drugs, including fentanyl, because of the potential for producing neonatal depression in doses that may not affect Apgar scores [28].…”

Section: Discussionmentioning

confidence: 99%

Neonatal welfare and placental transfer of fentanyl and bupivacaine during ambulatory combined spinal epidural analgesia for labour

Fernando¹,

Bonello

Gill³

et al. 1997

Anaesthesia

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SummaryTo investigate current concerns that potent opioid drugs, such as fentanyl, used for labour regional analgesia may affect neonatal status, maternal and umbilical plasma concentrations of fentanyl and bupivacaine at delivery were measured in 40 nulliparous patients receiving low-dose combined spinal epidural analgesia. Neonatal assessments included Apgar scores, umbilical blood gases and neurobehavioural tests. All maternal and umbilical venous plasma concentrations were low. Maternal and umbilical vein total fentanyl concentrations increased with increasing doses of epidural fentanyl (r ¼ 0.46 and 0.30, respectively, p < 0.01). There were no significant differences between maternal and umbilical venous plasma total or free concentrations of fentanyl. Mean umbilical vein/maternal fentanyl ratios were 1.12 for total drug and 1.20 for free drug and values were unrelated to the last epidural bolus to delivery interval (r ¼ 0.12, p ¼ 0.49). There were no correlations between Apgar scores, umbilical blood gases or neurobehavioural scores and umbilical venous concentrations of either fentanyl or bupivacaine. The dose of fentanyl used for ambulatory combined spinal epidural analgesia would appear to have a negligible effect on neonatal condition.

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“…At a lower dose rate, effective analgesia can be provided with minimal side effects.' - 4 In Dr Ewen's series, the 25 patients in Group A received 0.08% bupivacaine at 20 mg/hour. There were 12 hypotensive episodes in this group.…”

Section: Departmen T Of Anaestheticsmentioning

confidence: 99%