The effect of epidural anesthesia on uterine activity and blood pressure

Matadial, L; Cibils, Luis A.

doi:10.1016/0002-9378(76)90861-9

Cited by 37 publications

(4 citation statements)

References 15 publications

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“…A fall in blood pressure of more than 25 per cent of the control level was noted in 11 per cent of the present patients; in previous reports the frequency of hypotension has ranged from 18 to 39 per cent (Noble et al, 1971;Wingate et al, 1974). Combination of bupivacaine with adrenaline did not reduce the frequency of hypotension, which agrees with earlier observations (Matadial and Cibils, 1976).…”

Section: Discussionsupporting

confidence: 93%

“…Since parallel differences were seen in the block to delivery interval of both primigravidae and multigravidae, it is possible that adrenaline is absorbed from the epidural space into circulation, and depresses uterine contractions. Our own observations thus confirm some other investigations (Craft et al, 1972;Matadial and Cibils, 1976;Raabe and Belfrage, 1976a) which have shown that the addition of adrenaline to the analgesic agent in epidural analgesia diminishes uterine contractions.…”

Section: Discussionsupporting

confidence: 91%

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Fetal Heart Rate Patterns and Uterine Activity After Segmental Epidural Analgesia

Jouppila

Käär

et al. 1977

BJOG

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Summary The effects of low‐dose segmental epidural analgesia on fetal heart rate (FHR) patterns, uterine activity, and some clinical features were examined in a series of 105 normal parturients. The aim of the analgesic technique was to relieve pain during the first stage of labour by blocking the sensory nerve fibres at the spinal level of T 10 to T 12, with either 0·5 per cent bupivacaine or bupivacaine with adrenaline 1 : 200 000, the dose varying from 10 to 25 mg. Obvious pathological changes (late decelerations, prolonged fetal bradycardia, variable deceleration, or loss of beat to beat variation) in FHR patterns within the first 30 minutes after the beginning of analgesia were noted in 9 per cent of the patients. Addition of adrenaline to the analgesic agent seemed to reduce uterine activity for 60 minutes after the analgesia and this was reflected in a longer interval between the block and delivery. A 25 per cent fall in systolic blood pressure was recorded in 11 per cent of the patients. Nine patients required vacuum extractions. Our results show that the epidural technique employed has distinct advantages over the previous methods, which require larger doses of the analgesic agent, and is therefore safer for the fetus; the addition of adrenaline to the analgesic agent is contraindicated.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

Fetal Heart Rate Patterns and Uterine Activity After Segmental Epidural Analgesia

Jouppila

Käär

et al. 1977

BJOG

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“…Early investigators reported that induction of caudal or lumbar epidural analgesia resulted in a transient decrease in uterine contractility, lasting 10-30 min [39][40][41][42][43], The decrease in uterine activity in some of the studies was attributed to added epinephrine to the local anesthetic solution [41][42][43]. However, the rate of cervical dilation was not slowed by the temporary decrease in uterine con tractility [28,41].…”

Section: Effects On Progress Of Labormentioning

confidence: 99%

Lumbar Epidural Analgesia for Labor and Vaginal Delivery

Schabel¹,

Poppers²

1997

Gynecol Obstet Invest

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Lumbar epidural analgesia has become the preferred method of pain relief for labor and delivery. Proper administration of epidural analgesia offers many advantages for both mother and fetus. With the availability of various local anesthetics, opioids, and infusion techniques, the analgesia can be tailored to the specific needs of the mother, fetus, and labor. Its effect on the progress of labor remains a controversial topic subject to ongoing investigation.

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“…This causes foetal bradycardia and distress (Hon, 1968). The concomitant administration of vasoconstricting agents such as adrenaline causes a decrease in uterine activity and does not prevent the hypotension (Matadial and Cibils, 1975).…”

Section: Discussionmentioning

confidence: 99%

Sodium Nitroprusside for Aneurysm Surgery in Pregnancy

Donchin

Amirav

Sahar

et al. 1978

British Journal of Anaesthesia

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A 25-year-old woman in the 7th month of pregnancy was operated upon for a ruptured cerebral aneurysm. Sodium nitroprusside was used to achieve effective controlled hypotension. Signs of foetal distress were transient. Subsequent delivery was spontaneous and uneventful. Development of the child at 2 yr was satisfactory. The various physiological aspects and the action of nitroprusside on both mother and foetus are discussed.

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The effect of epidural anesthesia on uterine activity and blood pressure

Cited by 37 publications

References 15 publications

Fetal Heart Rate Patterns and Uterine Activity After Segmental Epidural Analgesia

Fetal Heart Rate Patterns and Uterine Activity After Segmental Epidural Analgesia

Lumbar Epidural Analgesia for Labor and Vaginal Delivery

Sodium Nitroprusside for Aneurysm Surgery in Pregnancy

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