Placental Passage and Uterine Effects of Fentanyl

Craft, John B.; Coaldrake, Lee A.; Bolan, Jean C.; Mondino, M.; Mazel, Paul; Gilman, Robin; Shokes, Leslie; Woolf, W. A.

doi:10.1097/00132586-198406000-00064

Cited by 21 publications

(7 citation statements)

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“…Because it is highly lipophilic, fentanyl rapidly crosses the placenta. In animal studies (sheep) it is present in the fetal blood within 1 minute and its level peaks at 5 minutes after maternal intravenous administration 48 . Fetal exposure to fentanyl is associated with temporary depressant effects such as fewer body movements between contractions, less overall time moving, and temporary abolishment of breathing movements at 10 minutes after dosing 49 .…”

Section: Fentanylmentioning

confidence: 99%

A Review of Systemic Opioids Commonly Used for Labor Pain Relief

Anderson

2011

J Midwife Womens Health

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Parenteral opioids for pain relief during labor have been the subject of research for many decades. Commonly used systemic opioids provide limited pain relief during labor yet are used extensively for managing labor pain. These opioids share similar pharmacologic profiles but differ in potency, pharmacokinetics, and side effects. This article reviews the pharmacokinetics, pharmacodynamics, and clinical research related to the commonly used systemic labor pain analgesics morphine, meperidine, fentanyl, remifentanil, butorphanol, and nalbuphine.

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Section: Fentanylmentioning

confidence: 99%

A Review of Systemic Opioids Commonly Used for Labor Pain Relief

Anderson

2011

J Midwife Womens Health

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“…Particularly with remifentanil that has a very short t 1/2 (elimination half-life), if a sample is taken just before or after the discontinuation of the infusion, significantly different plasma concentrations will be obtained. Chronically instrumented pregnant sheep are the most common species used to evaluate placental drug transfer and have been extensively used to examine the placental transfer of opioids like fentanyl (Craft et al, 1983) and sufentanil (Vertommen et al, 1995). But experiments from sheep may not reflect placental drug transfer in humans, for example because of the different nature of the placenta.…”

Section: Discussionmentioning

confidence: 99%

“…Chronically instrumented pregnant sheep are the most common species used to evaluate placental drug transfer and have been extensively used to examine the placental transfer of opioids like fentanyl (Craft et al ., 1983) and sufentanil (Vertommen et al ., 1995). But experiments from sheep may not reflect placental drug transfer in humans, for example because of the different nature of the placenta.…”

Section: Discussionmentioning

confidence: 99%

Transplacental transfer of remifentanil in the pregnant ewe

Coonen

Marcus

Joosten

et al. 2010

British J Pharmacology

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Background and purpose: While remifentanil can be used either during labour or fetal surgery, more should be known about the transplacental transfer of this opioid. The aim of this study was to investigate the placental transfer and haemodynamic effects of remifentanil after i.v. administration to pregnant ewes. ) for 1 h, and maternal and fetal arterial blood samples were drawn at regular intervals during and up to 1 h after the discontinuation of the infusion. Haemodynamic parameters were monitored continuously. Blood gas samples were drawn at baseline and once during the infusion. Key results: Peak maternal remifentanil plasma levels of 4.0 Ϯ 0.9 ng·mL -1 (mean Ϯ SD) and peak fetal plasma levels of 0.4 Ϯ 0.3 ng·mL -1 were obtained. Remifentanil plasma levels dropped rapidly after the discontinuation of the infusion. The continuous infusion of remifentanil did not result in significant maternal or fetal haemodynamic changes. Conclusions and implications:Remifentanil rapidly passes through the placenta of pregnant ewes and although remifentanil concentrations stay significantly lower in the fetus compared with those in the mother, remifentanil can be detected in significant amounts in the fetus.

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“…showed, the rapid rise and decline in fetal fentanyl blood concentration (appearance after 1 min with a peak at 5 min) after maternal i.v. injection of fentanyl 50–100 μg [13]. In humans, the ratio of umbilical vein concentration to maternal artery concentration (UV/MA) is 0.31 [14].…”

Section: Introductionmentioning

confidence: 99%