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Long duration peridural analgesia in labor by an association of bupivacaine and fentanyl

Long duration peridural analgesia in labor by an association of bupivacaine and fentanyl

Agressologie 29(1): 33-37

ISSN/ISBN: 0002-1148

A study was carried out to evaluate the neonatal effects of a bupivacaine-fentanyl mixture in long duration obstetric epidural analgesia. A series of 40 patients was studied. Epidural injections of 8 ml of bupivacaine 0.25% without adrenaline but with 50 .mu.g of fentanyl were made four times in 31 patients, five times in sept patients and six times in two patients. Foetal cardiac rhythm and uterine contractions were monitored continuously during labor and the following parameters were assessed: the interval between the last drug injection and the delivery, the neurological and adaptive capacity score and blood gases in the newborn, the maternal and foetal plasma fentanyl concentrations. The maternal side effects of fentanyl (essentially itching) were the same as those found in other studies. Acute foetal suffering was noted in eleven cases, of which five required reanimation. At birth all other newborn had a maximal neurological and Apgar's score at five minutes. Average plasma fentanyl concentrations were respectively 0.74 .+-. 0.13 ng per ml in mothers and 0.36 .+-. 0.04 ng per ml in newborns, the ratio bieng 0.49. These results show a newborn plasma fentanyl concentration lower than expected from the results of previous studies, and the absence of correlation between acute foetal suffering and newborn plasma fentanyl concentration.

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Accession: 005827162

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