Effects of intrathecal sufentanil on plasma oxytocin and cortisol concentrations in women during the first stage of labor

Abstract

Intrathecal sufentanil analgesia decreases plasma concentrations of oxytocin and cortisol in women with labor pain during the first stage of labor, but epidural bupivacaine only reduced the cortisol concentration.

Effects on mother and fetus of epidural and combined spinal-epidural techniques for labor analgesia

“…Cited studies showed no evidence of alterations in the newborn condition after high doses of subarachnoid opioids; this is based on Apgar scores, umbilical cord arterial blood gases, or admission to intensive care unit. 26 conclusIon EA and CSE analgesia relieved maternal pain during obstetric analgesia, but CSE mothers had pruritus and a longer labor. Newborns of mothers who received epidural analgesia showed the best neurological and adaptive capacity score.…”

Physiological mechanisms, behavioral and psychological factors influencing the transfer of milk from mothers to their young

“…Some studies found that women who received EDA had lower circulating OT levels during labor (Goodfellow et al, 1983;Rahm et al, 2002;Stocche et al, 2001), whereas others did not (de Geest et al, 1985;Scull et al, 1998). It appears that the closer to EDA administration blood samples are obtained, the less pronounced the effect of EDA on OT levels.…”

O tempo e a anestesia obstétrica: da cosmologia caótica à cronobiologia

“…The challenges of toco-anesthesia in high risk pregnancies and the safety of the maternal-fetal binomium in premature labor are faced by conventional regional and systemic pharmacological methods. In spinal blocks, some items are mandatory: six-to eight-hour fasting to prevent chemical pneumonitis due to aspiration of gastric contents; control of maternal hypotension and fetal hypoxia (acidosis) by moving the uterus to the left, volume expansion, administration of vasopressors (ephedrine, phenylephrine, metaraminol), and rapid fetal extraction after uterotomy (UD interval, uterotomy-delivery, lower than three minutes) 24,[45][46][47][48][49][50][51][52][53][54] . The incidence of cesarean section at the Maternidade-Escola J Cicco (UFRN-SUS) is higher than 40%, i.e., lower than the 70% incidence in private hospitals (Natal, RN, Brazil).…”

“…Neurohumoral changes justify the lower intensity of matutinal and evening pain, since there is an abundance of central anti-nociceptive neurotransmitters: endorphins, enkephalins, and noradrenaline, during the day (light phase). Besides the nocturnal increase in melatonin, serotonin, and acetylcholine (anti-nociceptive), a drastic reduction in the levels of endorphins, corticosteroids, as well as the elevation of pro-nociceptive mediators (histamine, PG, oxytocin, cytokines) are also seen [47][48][49] .…”

“…Crushing of blood vessels in the myometrium by sustained muscular contraction, the classical "living ligatures", controls bleeding by indirect vasoconstriction 49 . On the other hand, bleeding caused by autonomic sympathetic arterial dysfunction parallels circadian variations in blood pressure.…”