Placental Transfer and Neonatal Effects of Epidural Sufentanil and Fentanyl Administered with Bupivacaine During Labor

Loftus, Jessica; Hill, Harlan F.; Cohen, Sheila E.

doi:10.1097/00132586-199608000-00024

Cited by 48 publications

(61 citation statements)

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“…According to the authors one explanation for these FHR changes could be a direct depressant effect of opioids as was determined for morphine and pethidine by Petrie et al [18]. Although epidural sufentanil in therapeutic doses (10 µg -30 µg of sufentanil in the epidural mixture) is detectable in the maternal circulation [19], it seems unlikely that these low doses used for epidural analgesia have any important systemic impact [19,20]. increasingly popular as a method for labour pain relief as it has a very rapid onset of analgesia.…”

Section: Epidural Analgesiamentioning

confidence: 96%

Labour analgesia effects on foetal heart rate. A mini-review

Engel¹,

Velde²,

Nijhuis³

et al. 2011

OJOG

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Foetal well-being during labour is of utmost importance. One of the ways to attempt to assess foetal wellbeing is by recording foetal heart rate (FHR). Loss of variability and deceleration patterns are known to be associated with foetal distress. Decelerations and foetal bradycardia have been described after any type of effective labour analgesia. This review addresses the questions if certain analgesic techniques and/or analgesics lead to clinically relevant FHR changes, what is their aetiology, and how we should manage these FHR changes.

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Section: Epidural Analgesiamentioning

confidence: 96%

Labour analgesia effects on foetal heart rate. A mini-review

Engel¹,

Velde²,

Nijhuis³

et al. 2011

OJOG

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“…Dünyada ve ül-kemizde hızla kullanımı artan ve doğum ağrısının rahatlatılmasında çok etkili bir yöntem olan epidural anestezinin emzirmeye başlamaya ve emzirme sürecine olumsuz etkileri olduğu belirtilmektedir (5)(6)(7)(8)(9). Epidural anestezide kullanılan ilaçların, plesanta aracılı ile fetüse geçtiği ve bu durumun doğumdan sonra bebeğin reflekslerini etkilediği düşünülmektedir (10). Literatürde epidural anestezi kullanımının yenidoğanın nörolojik davranışlarını ve etkin emzirmeyi etkilemediğini belirten farklı çalışmalar da bulunmaktadır (11,12).…”

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Epidural anestezi ile vajinal doğum yapan ve anestezisiz vajinal doğum yapan primipar annelerde ilk 24 saatte etkili emzirmenin değerlendirilmesi

VURAL¹

2015

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Amaç: Araștırma epidural anestezi ve anestezisiz vajinal doğum yapan primipar kadınların ilk 24 saatte etkili emzirmelerinin değerlendirilmesi amacıyla karșılaștırmalı ve betimsel olarak yapıldı. Gereç ve Yöntem:Araștırmanın örneklemini, anestezisiz doğum yapmıș 40 anne ile epidural anestezi ile doğum yapan 40 anne olușturdu. Verilerin toplanmasında veri toplama formu ve LATCH Emzirme Tanılama Ölçüm Aracı kullanıldı. Her anne doğumdan sonra ilk 24 saatte 3 kez değerlendirildi. Verilerin değerlendirilmesinde yüzdelik hesaplanması, Pearson ki-kare, Mann-Whitney U ve Fisher's Exact Testleri kullanıldı. Bulgular: Annelerin %60'ı ilk 30 dakika içinde bebeğini emziremedi. Emzirmeye bașlama zamanı açısından iki grup arasında istatistiksel olarak önemli bir fark tespit edilmedi (p>0,05). Bebeklerin uyku hali, emmeye ait refleksleri, APGAR skorları ve LATCH puanları açısından iki grup arasında istatistiksel olarak önemli bir fark bulunmadı (p>0,05). 24. saatte emme sırasında bebeğin șakaklarında hareket olma durumunun anestezisiz olan grupta daha yüksek olduğu bulundu (p<0,05). Epidural grubunda 12. ve 24. saatlerde meme ucunda ağrı șikayeti yüksek bulundu (p<0,05). Çalıșmamızda epidural uygulanan grupta 'sütüm yok, meme ucumu sıktığımda süt gelmiyor' șikayeti daha yüksek oranda ifade edildi. Sonuçlar: Araștırma sonuçlarımıza göre, epidural anestezi bebeğin emme reflekslerini ve emmesini olumsuz etkilemeden süt salınımını geciktirebilmektedir.Anahtar Sözcükler: Anne Sütü, Emzirme, Epidural Anestezi Aim: The purpose of the study was to evaluate the breastfeeding during the first 24 hours in nulliparous mothers who had a vaginal birth with or without epidural anaesthesia. Material and Method:Study cohorts consited of 40 mothers who had vaginal birth with epidural anesthesia and 40 mothers who had birth without anesthesia. A data collection form and the LATCH Breast Feeding Point System were used. Each mother was evaluated three times in a 24-hour period in the hospital.Results: Sixty percent of mothers in each group did not breastfeed within the first 30 minutes. There was no significant difference between two groups for the time of beginning to feed the baby (p>0,05). There were no significant difference between baby's sleeping situation and reflexes of sucking (p>0,05). No differences were diagnosed by first and fifth minutes APGAR scores (p>0,05). No meaningful differences were observed in 6th 12th and 24th hours by LATCH points. At 24 th hour, baby's temple moving was higher in without anesthesia group (p<0,05). In epidural group, 12 th and 24 th hours nipple-ache complaints were higher (p<0,05). In our research there was no meaningful difference of situation at sufficiency of milk. Complaints of milk's insufficient quantity was higher in mother with epidural group. Conclusion:Epidural anaesthesia does not effect babies sucking reflexes, but, complaints of insufficient milk were more common in the epidural group and delays milk secretion.Key Words: Human Milk, Breastfeeding, Epidural Anesthesia Büyüme ve gelişmenin en ...

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“…Babies who were born to mothers receiving epidural anesthesia scored significantly better on alertness at ages 3 hours, 2 days, and 4 to 5 days and better on sucking at 3 hours. 6 The effects of epidural anesthesia on neurologic parameters can vary from agent to agent, 10 and can be due to direct effects of the medication on the infant or indirect effects on the neonate, delivery process, or infant-mother interaction. 8 The effects can also be subtle but unmasked when studied in combination with other factors, such as labor length, parity, and ponderal index.…”

mentioning

confidence: 99%

Effect of Labor Epidural Anesthesia on Breast-feeding of Healthy Full-term Newborns Delivered Vaginally

Baumgarder¹,

Muehl²,

Fischer³

et al. 2003

The Journal of the American Board of Family Medicine

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Background: Epidural anesthesia is commonly administered to laboring women. Some studies have suggested that epidural anesthesia might inhibit breast-feeding. This study explores the association between labor epidural anesthesia and early breast-feeding success.Methods: Standardized records of mother-baby dyads representing 115 consecutive healthy, fullterm, breast-feeding newborns delivered vaginally of mothers receiving epidural anesthesia were analyzed and compared with 116 newborns not exposed to maternal epidural anesthesia. Primary outcome was two successful breast-feeding encounters by 24 hours of age, as defined by a LATCH breast-feeding assessment score of 7 or more of 10 and a latch score of 2/2. Means were compared with the KruskalWallis test. Categorical data were compared using the Mantel-Haenszel chi-square test. Stratified analysis of potentially confounding variables was performed using Mantel-Haenszel weighted odd ratios (OR) and chi-square for evaluation of interaction.Results: Both epidural and nonepidural anesthesia groups were similar except maternal nulliparity was more common in the epidural anesthesia group. Two successful breast-feedings within 24 hours of age were achieved by 69.6% of mother-baby units that had had epidural anesthesia compared with 81.0% of mother-baby units that had not (odds ratio [OR] 0.53, P ‫؍‬ .04). These relations remained after stratification (weighted odds ratios in parenthesis) based on maternal age (0.52), parity (0.58), narcotics use in labor (0.49), and first breast-feeding within 1 hour (0.49). Babies of mothers who had had epidural anesthesia were significantly more likely to receive a bottle supplement while hospitalized (OR 2.63; P < .001) despite mothers exposed to epidural anesthesia showing a trend toward being more likely to attempt breast-feeding in the 1 hour (OR 1.66; P ‫؍‬ .06). Mothers who had epidural anesthesia and who did not breast-feed within 1 hour were at high risk for having their babies receive bottle supplementation (OR 6.27). Conclusions

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Placental Transfer and Neonatal Effects of Epidural Sufentanil and Fentanyl Administered with Bupivacaine During Labor

Cited by 48 publications

References 0 publications

Labour analgesia effects on foetal heart rate. A mini-review

Labour analgesia effects on foetal heart rate. A mini-review

Epidural anestezi ile vajinal doğum yapan ve anestezisiz vajinal doğum yapan primipar annelerde ilk 24 saatte etkili emzirmenin değerlendirilmesi

Effect of Labor Epidural Anesthesia on Breast-feeding of Healthy Full-term Newborns Delivered Vaginally

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