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Summary
The present study was designed to assess the effect of adrenaline on the plasma concentrations
of fentanyl in mothers and umbilical vessels after epidural administration for caesarean
section.
Thirty patients undergoing elective caesarean section were allocated randomly into
two groups. Group 1 (n = 16) received 100 μg fentanyl, 10 ml of 0.5% bupivacaine and
10 ml 2% lidocaine, while group II (n = 14) received 100 μg fentanyl, 10 ml of 0.5%
bupivacaine with adrenaline 1:200 000, and 10 ml of 2% lidocaine with adrenaline 1:80
000. Blood samples were obtained from the maternal antecubital vein (MV) at various
times up to 6 hours after epidural injection, and from umbilical vein (UV) and arteries
(UA) at birth for determination of plasma fentanyl by radioimmunoassay.
Fentanyl Cmax and Tmax in MV did not differ significantly between the two groups. In umbilical vessels,
plasma fentanyl concentrations were comparable in the two groups: (0.12 ± 0.08 ng
ml−1 and 0.13 ± 0.08 ng ml−1 in UV and 0.08 ± 0.07 ng ml−1 and 0.06 ± 0.05 ng ml1 in UA of groups I and II respectively). The maximum plasma concentration in UV was
0.24 ng ml−1 in group I and 0.25 ng ml−1 in group II. There was no significant correlation between umbilical vessel (vein
or artery):MV ratio and dose to delivery interval and no difference between the two
groups in Apgar score or umbilical cord pH.
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© 1995 Pearson Professional Ltd. Published by Elsevier Inc.