The Maternal and Fetal Cardiovascular Effects of Epidural Fentanyl in the Sheep Model

Craft, John B.; Robichaux, A. C.; Kim, H. S.; Thorpe, David; Mazel, Paul; Woolf, W. A.; Stolte, A. L.; Neumark, Julius

doi:10.1097/00132582-198412000-00033

Cited by 5 publications

(2 citation statements)

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“…However, these results were contradicted in a study by Preston and others, who reported normal Apgar scores, normal neurobehaviour and adaptive capacity scores (NACS), and neonatal blood levels at delivery which were below the level expected to cause respiratory depression [50]. Similar conclusions were reached in a study in pregnant sheep by Craft et al ., in which the placental passage and uterine effects after epidural fentanyl were investigated [51]. They showed that an epidural injection of fentanyl 50 μg has little effect on maternal or fetal cardiovascular and acid base status, uterine tone and uterine blood flow.…”

Section: Introductionmentioning

confidence: 99%

Opioids in obstetrics: which route of administration with which opioid do we choose to establish effective analgesia?

1998

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Section: Introductionmentioning

confidence: 99%

Opioids in obstetrics: which route of administration with which opioid do we choose to establish effective analgesia?

1998

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“…These drugs are known to be rapidly distributed to the fetus and to produce CNS depres sion and other pharmacological effects [Way et ah, 1965;Zelson et ah, 1973;Kuhnert et ah, 1979;Lieberman et ah, 1979;Eiseleetal., 1981 ;Szeto, 1982;Craft et al, 1982;Olsen et al, 1983]. In order to establish optimal agents and dose ranges for therapeutic use of opiates during pregnancy, quantitative information on maternal-fetal distribution of these agents has been sought using animal models.…”

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confidence: 99%

Maternal-Fetal Distribution of Morphine and Alfentanil in Near-Term Sheep and Rhesus Monkeys

Golub¹,

Eisele²,

Anderson³

1986

Dev Pharmacol Ther

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Maternal-fetal distribution of the opiate agents morphine and alfentanil was studied in 3 near-term sheep and rhesus monkeys. Blood samples were obtained from maternal and fetal arteries for radioimmunoassay after placement of catheters under halo- thane anesthesia. Fetal-maternal ratios (F/M) of plasma morphine concentrations for sheep increased from 0.04 to 0.47 during the first hour after bolus IV injection of 200 pg/kg morphine. However, in monkeys, F/M values were considerably higher, increasing from 0.27 to 1.85. Indeed, values over 1.00, indicating higher drug concentrations in fetal than maternal plasma, were seen in two monkeys at 10 and 60 min time points. For alfentanil, a more lipid soluble but highly protein-bound drug, F/M values of plasma concentrations were similar in the two species ranging from 0.1 to 0.6 after injection of 250 pg/kg in sheep and 125 μg/kg in monkeys. Quantitation of morphine glucuronide, the principal metabolite of morphine and total morphine-like immunoactivity, suggested that morphine was metabolized more rapidly in monkey dams than in sheep, and that morphine glucoronide was more readily distributed to monkey than sheep fetus. These data suggest that morphine, but not alfentanil, transfers more readily from dam to fetus in near-term monkeys than in sheep.

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Influence of intravenous fentanyl on fetal biophysical parameters during labor

Smith¹,

Rayburn²,

Allen³

et al. 1996

J. Matern. Fetal Med.

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The short‐acting opioid fentanyl has been shown to be a useful analgesic during labor. The purpose of this prospective, comparative investigation was to determine whether fentanyl influenced fetal biophysical parameters during labor. Twenty‐four uncomplicated pregnancies at 37–41 weeks were studied during the early active phase of labor. Those patients who requested analgesia (study group) were given a standard 50‐μg dose of fentanyl intravenously. The study (N = 12) and control (N = 12) groups were similar in maternal age, parity, and gestational age distribution. Fetal body and breathing movements and heart rate patterns were evaluated continuously for 80 min at 10‐min epochs. Unlike the control group, fetuses exposed to fentanyl had fewer body movements between contractions (P < 0.03) and spent less overall time moving (P < 0.02). Breathing was abolished at 10 min postdosing in all fetuses exposed to fentanyl but not in the control group. The FHR beat‐to‐beat variability was reduced between contractions for the first 30 min in 8 (66%) of study cases and none of the control cases (P < 0.01). A sine wave‐like FHR pattern was observed for 30 min in two fetuses exposed to fentanyl. All infants had 1‐ and 5‐minute Apgar scores >6, an umbilical artery pH > 7.20, and no need for resuscitation. In conclusion, an intravenous dose of fentanyl during early active labor was associated with temporary depressant effects on many fetal biophysical parameters without apparent harm being observed at delivery. © 1996 Wiley‐Liss, Inc.

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The Maternal and Fetal Cardiovascular Effects of Epidural Fentanyl in the Sheep Model

Cited by 5 publications

References 0 publications

Opioids in obstetrics: which route of administration with which opioid do we choose to establish effective analgesia?

Opioids in obstetrics: which route of administration with which opioid do we choose to establish effective analgesia?

Maternal-Fetal Distribution of Morphine and Alfentanil in Near-Term Sheep and Rhesus Monkeys

Influence of intravenous fentanyl on fetal biophysical parameters during labor

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