Anesthésie péridurale pour césarienne par association bupivacaïne-fentanyl

Milon, D.; Bentué-Ferrer, Danièle; Noury, D.; Reymann, Jean-Michel; Sauvage, J. P.; Allain, H.; Saint-Marc, Cécile; Driessche, Jean Van Den

doi:10.1016/s0750-7658(83)80024-0

Cited by 20 publications

(6 citation statements)

References 24 publications

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“…However, two cases of respiratory depression after 100 pg epidural fentanyl were described (see results). Epidurally administered fentanyl crosses the placenta and reaches the foetus (9, 36,42). Thus, effects on the newborn and rare occurrence of respiratory depression cannot be ruled out.…”

Section: Discussionmentioning

confidence: 99%

“…One trial (36) was not randomized and 6 (36-41) were not double-blind. Only 4 investigations mentioned an external financial support, which was provided by a drug company (42) and an institution (10,14,43), respectively.…”

Section: Characteristics Of Selected Trialsmentioning

confidence: 99%

“…Meta-analysis for Apgar score was performed on the 7 papers (8, 10,36,42,45,47,51) reporting mean values (Table 5, 6). In two other papers (9, 52) mean values were not specified, but it was stated that scores were equal to or greater than 7 after 1 min and equal to or more than 8 after 5 min in all newborns of both groups.…”

Section: Fig 2 Odds Ratios and 95% Confidence Intervals Of Individumentioning

confidence: 99%

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Epidural fentanyl, adrenaline and clonidine as adjuvants to local anaesthetics for surgical analgesia: meta‐analyses of analgesia and side‐effects

Curatolo

Petersen-Felix

Scaramozzino

et al. 1998

Acta Anaesthesiol Scand

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The analysis of current literature shows that the addition of fentanyl to local anaesthetics for intraoperative epidural analgesia is safe and advantageous. The reduction in the incidence of pain during surgery is quantitatively high and therefore clinically significant. Side-effects are mild. Randomized, controlled trials have to be performed in order to clarify the role of adrenaline and clonidine as epidural adjuvants for surgical analgesia.

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Section: Discussionmentioning

confidence: 99%

Section: Characteristics Of Selected Trialsmentioning

confidence: 99%

Section: Fig 2 Odds Ratios and 95% Confidence Intervals Of Individumentioning

confidence: 99%

See 1 more Smart Citation

Epidural fentanyl, adrenaline and clonidine as adjuvants to local anaesthetics for surgical analgesia: meta‐analyses of analgesia and side‐effects

Curatolo

Petersen-Felix

Scaramozzino

et al. 1998

Acta Anaesthesiol Scand

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“…Koehntop et al [30] reported a mean plasma fentanyl concentration of 0.37 ng.ml -1 at tracheal extubation in neonates given varying doses of fentanyl intravenously during anaesthesia and ventilated postoperatively for nonsurgical reasons. Milon et al [31], using epidural fentanyl with bupivacaine for Caesarean section, found umbilical arterial (UA) fentanyl concentrations well below respiratory depressant levels [29,32]. Carrie et al [33], after a bolus of 150-200 mg of epidural fentanyl, reported UA fentanyl concentrations ranging from 0.1 to 0.25 ng.ml -1 with a median value of 0.18 ng.ml -1 .…”

Section: Discussionmentioning

confidence: 99%

Neonatal welfare and placental transfer of fentanyl and bupivacaine during ambulatory combined spinal epidural analgesia for labour

Fernando¹,

Bonello

Gill³

et al. 1997

Anaesthesia

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SummaryTo investigate current concerns that potent opioid drugs, such as fentanyl, used for labour regional analgesia may affect neonatal status, maternal and umbilical plasma concentrations of fentanyl and bupivacaine at delivery were measured in 40 nulliparous patients receiving low-dose combined spinal epidural analgesia. Neonatal assessments included Apgar scores, umbilical blood gases and neurobehavioural tests. All maternal and umbilical venous plasma concentrations were low. Maternal and umbilical vein total fentanyl concentrations increased with increasing doses of epidural fentanyl (r ¼ 0.46 and 0.30, respectively, p < 0.01). There were no significant differences between maternal and umbilical venous plasma total or free concentrations of fentanyl. Mean umbilical vein/maternal fentanyl ratios were 1.12 for total drug and 1.20 for free drug and values were unrelated to the last epidural bolus to delivery interval (r ¼ 0.12, p ¼ 0.49). There were no correlations between Apgar scores, umbilical blood gases or neurobehavioural scores and umbilical venous concentrations of either fentanyl or bupivacaine. The dose of fentanyl used for ambulatory combined spinal epidural analgesia would appear to have a negligible effect on neonatal condition.

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“…With the patient in the lateral position, extradural puncture was performed at either the T12 space for ESWL or the L2 space for knee arthroscopy. After a test dose of 2 % lignocaine 3 ml with adrenaline 1 in 200000, 9 ml (T12) or 17 ml (L2) of the same anaesthetic solution with or without fentanyl 50 ng was injected slowly (9) 172 (13) 168 (10) 169 772 (18) 70 (15) 69 (10) through the Tuohy needle. The spread of sensory block was assessed by altered sensation to pinprick at the time of the first postoperative carbon dioxide rebreathing test (i.e.…”

Section: Extradural Anaesthesiamentioning

confidence: 99%

Ventilatory Response to Carbon Dioxide During Extradural Anaesthesia With Lignocaine and Fentanyl

Morisot¹,

Dessanges²,

Regnard³

et al. 1989

British Journal of Anaesthesia

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Twenty-seven patients undergoing extracorporeal shock-wave lithotripsy or knee arthroscopy received extradural anaesthesia with 2% lignocaine plus adrenaline 1 in 200,000. They were allocated randomly to three groups, one receiving no fentanyl (n = 6), the two others receiving fentanyl 50 micrograms either extradurally (n = 15) or i.v. (n = 6). Three tests of sensitivity to carbon dioxide (Read's method) were performed successively on each patient: before operation and at 1 and 2 h after the extradural injection. Whereas lignocaine and adrenaline alone had no significant effects on basal ventilation and the ventilatory response to carbon dioxide, extradural fentanyl caused a slight reduction in resting ventilatory rate and ventilation at 1 and 2 h with no change in resting end-tidal carbon dioxide concentration. In addition, the slope of the ventilatory response to carbon dioxide was reduced slightly at 1 h and ventilation at end-tidal PCO2 of 7.3 kPa was reduced also at 1 and 2 h. Conversely, the same dose of fentanyl i.v. had lesser and shorter effects on ventilation at rest and during carbon dioxide rebreathing. Our results show that fentanyl 50 micrograms given extradurally caused slight ventilatory depression which is probably clinically unimportant.

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Anesthésie péridurale pour césarienne par association bupivacaïne-fentanyl

Cited by 20 publications

References 24 publications

Epidural fentanyl, adrenaline and clonidine as adjuvants to local anaesthetics for surgical analgesia: meta‐analyses of analgesia and side‐effects

Epidural fentanyl, adrenaline and clonidine as adjuvants to local anaesthetics for surgical analgesia: meta‐analyses of analgesia and side‐effects

Neonatal welfare and placental transfer of fentanyl and bupivacaine during ambulatory combined spinal epidural analgesia for labour

Ventilatory Response to Carbon Dioxide During Extradural Anaesthesia With Lignocaine and Fentanyl

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