This paper is only available as a PDF. To read, Please Download here.
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.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to International Journal of Obstetric AnesthesiaAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Extradural, spinal or combined block for obstetric surgical anaesthesia.Br J Anaesth. 1990; 65: 225-233
- Epidural bupivacaine-fentanyl anaesthesia for caesarean section.Ann Fr Anesth Reanim. 1983; 2: 273-279
- Surgical analgesia for cesarean delivery with epidural bupivacaine and fentanyl.Anesthesiology. 1986; 65: 331-334
- Epidural anesthesia with fentanyl and lidocaine for cesarean section: Maternal effects and neonatal outcome.Anesthesiology. 1988; 68: 938-943
- Epidural fentanyl and 0,5% bupivacaine for elective caesarean section.Anaesthesia. 1990; 45: 285-288
- Maternal and umbilical cord concentrations of fentanyl after epidural analgesia for cesarean section.Eur J Obstet Gynecol Reprod Biol. 1991; 42: 89-94
- Epidural fentanyl in labour.Anaesthesia. 1981; 36: 965-969
- Plasma concentrations of bupivacaïne during continuous epidural analgesia in labour: The effect of adrenaline.Br J Anaesth. 1971; 43: 436-440
- Epidural anesthesia with lidocaine and bupivacaine: Effects of epinephrine on the plasma concentration profiles.Anesth Analg. 1986; 65: 1281-1284
- Effect of adrenaline on extradural anaesthesia, plasma lignocaine concentrations and the fetoplacental unit during elective caesarean section.Br J Anaesth. 1991; 67: 688-689
- Epidural lidocaine for cesarean section: Effect of varying epinephrine concentration.Anesthesiology. 1988; 69: 936-940
- Effect of adrenaline on extradural anaesthesia and plasma bupivacaine concentrations during caesarean section.Br J Anaesth. 1988; 60: 180-186
- Intérêt de la mesure du pH sanguin dans la surveillance fœtale pendant l'accouchement.J Gynecol Obstet Biol Reprod. 1978; 7: 1065-1077
- A sensitive radioimmunoassay for fentanyl.Eur J Clin Pharmacol. 1977; 12: 153-158
- Fentanyl RIA improved by a single-step extraction.Clin Chem. 1988; 34: 2157
- Epidural fentanyl with and without epinephrine plasma levels and pain relief.Anesthesiology. 1988; 69: A 391
- Maternal and foetal plasma concentrations of bupivacaine after epidural block.Br J Anaesth. 1973; 45: 1049-1053
- Primary spinal anesthetic effects of epinephrine.Anesth Analg. 1950; 29: 156-162
- Pharmacology of spinal adrenergic systems which modulate spinal nociceptive processing.Pharmacol Biochem Behav. 1985; 22: 845-858
- Epidural Fentanyl in labour; An evaluation of the systemic contribution to analgesia.Anaesthesia. 1985; 40: 741-747
- A double-blind comparison of epidural bupivacaine and bupivacaine-fentanyl for caesarean section.Anaesth Intensive Care. 1990; 18: 22-30
Article info
Identification
Copyright
© 1995 Pearson Professional Ltd. Published by Elsevier Inc.
