Fetal Heart Rate Abnormalities After Regional Analgesia for Labor Pain: The Effect of Intrathecal Opioids. Issue 3 (1st May 2001)

• Record Type: Journal Article
• Authors: Velde, Marc Van de; Vercauteren, Marcel; Vandermeersch, Eugène
• Is Part Of: Regional anesthesia and pain medicine. Volume 26:Issue 3(2001)
• Page Start: 257
• Page End: 262
• Publication Date: 2001-05-01
• Subjects: Anesthesia -- Obstetric -- Labor -- Opioids -- Sufentanil -- Complications; Conduction anesthesia -- Periodicals; Pain medicine -- Periodicals; 617.964
• DOI: 10.1053/rapm.2001.22258
• Languages: English
• ISSNs: 1098-7339

Abstract

Abstract : Background and Objectives: Intrathecal opioids used to relieve labor pain have been associated with uterine hyperactivity and nonreassuring fetal heart rate abnormalities. We retrospectively evaluated all charts of singleton, term, vertex-presenting parturients in active labor requesting neuraxial pain relief during a 1-year period for the occurrence of nonreassuring fetal heart rate tracings. Methods: Three different strategies to relieve labor pain were routinely used in our department: conventional epidural using 10 mL bupivacaine 0.125% and sufentanil 0.75 μ g/mL; combined spinal and epidural (CSE) using intrathecal sufentanil (7.5 μ g); and CSE using intrathecal bupivacaine (2.5 mg) and sufentanil (1.5 μg). Charts (n = 1, 293) were evaluated for nonreassuring fetal heart tracings and uterine hyperactivity as well as for neonatal and labor outcome. Results: Intrathecal sufentanil (7.5 μ g) produced significantly more nonreassuring tracings and uterine hyperactivity. However, this did not result in more cesarean deliveries or detrimental neonatal outcome. Conclusion: Based on this retrospective analysis, we conclude that intrathecal sufentanil in a dose of 7.5 μ g has the potential to result in more nonreassuring fetal heart rate tracings compared with both intrathecal analgesia using a bupivacaine (2.5 mg)/sufentanil (1.5 μ g) mixture and epidural analgesia using bupivacaine, sufentanil, and epinephrine.